Overview
what it is and why it mattersA patella fracture is a break in your kneecap. It usually happens one of two ways: a direct hit (landing knee-first on the ground, slamming into a car dashboard), or your own quadriceps muscle pulling so hard during a stumble that it yanks the kneecap in two. The kneecap is the anchor in a chain that lets you straighten your leg — the quadriceps muscle, its tendon, the kneecap, the patellar tendon below it, and the bump on your shin where it attaches. If a fracture breaks that chain, you can't straighten your leg, and you need surgery to put it back together.
Symptoms
what you may noticeSharp pain in the front of your knee right after a fall or blow, rapid swelling over the kneecap, and the feeling that your leg won't straighten against gravity. You may be able to feel a gap or step-off right through the skin where the kneecap has split apart.
Bruising typically spreads down the shin over the first day or two. If you can still straighten your leg, the fracture may be non-displaced — but even then, putting weight on the knee is painful and the knee feels unstable when you try to walk.
Diagnosis
exam first, imaging secondPain in the front of the knee, swelling, and the inability to lift your straight leg off the bed against gravity is the giveaway — when the kneecap is broken in two, the pull-chain that straightens your leg no longer works. Sometimes you can feel a step or gap right on the kneecap with your finger. Three X-ray views of the knee confirm the fracture and how far apart the pieces are. A CT scan adds detail when the bone is shattered into many fragments.
Treatment Path
how care progresses at OSI1
Non-operative management
If the fracture lines haven't shifted and you can still straighten your leg, surgery isn't always needed. The leg goes into a cylinder cast or hinged brace locked straight for the first stretch of healing, with gradual weight-bearing as the bone knits back together.
Surgical Options at OSI
if non-operative care isn't enoughSurgery is needed when the fragments have pulled apart more than a few millimeters, when the bone is shattered into many pieces and you can't straighten your leg, when the skin is torn open over the fracture (an open fracture), or when an infection in the bone develops.
Providers Who Treat Patella Fracture
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: