Carenotes > Patellar Fracture In Children

Patellar Fracture In Children

GENERAL INFORMATION:

What is a patellar fracture? A patellar (pah-TEL-er) fracture (FRAK-chur) is a break in your child's kneecap. The patella is a thick, triangular bone that protects the front of your child's knee joint. The patella also helps your child's thigh muscles to straighten out the knee.

Patella fractures may be a single crack or break. This may or may not move the patella out of its original position. The patella may also break up into many pieces. Patellar fractures may also affect the tendons, ligaments, and blood vessels around the affected knee. This is called a complicated fracture and often needs immediate treatment, such as surgery. With treatment, such as surgery and medicine, your child will usually be able to return to his previous activities.

What causes a patellar fracture? A patellar fracture is usually caused by a direct blow to your child's knee. This may occur in a car accident or a hard fall on the knees. Patellar fractures in children sometimes occur after a rapid contraction (tightening) of the thigh muscles. This contraction strongly pulls the tendon attached to the kneecap and thigh muscles which breaks the patella. Patellar fractures can occur in sporting activities that require forceful jumping, such as skateboarding, hurdles, and the high jump.

What are the signs and symptoms of a patellar fracture? Your child may suddenly feel a severe pain in front of the knee. Swelling and bruising may also be seen. Your child may have trouble walking or putting weight on the affected knee. He may also have difficulty in raising the affected leg while lying down.

How is a patellar fracture diagnosed? Your child may have one or more of the following tests:

• X-rays: Your child will need x-rays of the affected leg to check for broken bones or other problems. Several pictures may be taken of the bones in your child's leg. An x-ray of his uninjured leg may also be taken.
  
  
• Computerized tomography scan: This test is also called a CT or CAT scan. This is a type of x-ray that uses a computer to take pictures of your child's leg. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your child's caregiver if your child is allergic to shellfish or has other allergies or medical conditions.
  
  
• Magnetic resonance imaging scan: This test is also called an MRI. The test uses magnetic waves to take pictures of your child's knee area.
  
  
• Bone scan: During this test, pictures are taken of your child's bones. Your child is given a small, safe amount of radioactive dye in an IV. Caregivers can look at the pictures for broken bones, infection, or cancer in the bones.
  
  
• Ultrasound: This is a test using sound waves to look at your child's knee. Pictures of your child's knee show up on a TV-like screen.

How is a patellar fracture treated? Treatment will depend on the kind of fracture your child has. Your child may need one or more of the following:

• Cast or splint: Keeping the broken knee from moving after surgery is very important. A cast or splint may be put on your child's knee to keep the patellar bone from moving.
  
  
• Medicines: Medicines may be given to help with your child's pain. Your child may need an antibiotic or tetanus shot if the fracture also has an open wound.
  
  
• Supportive therapy: Ice packs may be put on your child's knee to decrease swelling, pain, and redness. Physical therapy may be needed once swelling and pain are gone. A physical therapist may assist your child with special exercises. This may help his leg and knee recover faster and become stronger. Your child may have to use crutches to help him walk. Crutches will also help your child take some weight off the injured knee while it heals.
  
  
• Surgery: Surgery is sometimes needed for complicated patellar fractures. Caregivers may make an incision (cut) on your child's knee to line up the broken pieces of the patella. Wires, screws, or tension bands may be used to hold the fractured patella, tendons, and ligaments in place. Surgery, to remove small pieces of broken patella, may also be done.

With treatment, such as surgery and medicine, your child will usually be able to return to his previous activities.

Where can I find more information? Having a patellar fracture may be hard for your child and your family. Contact the following for more information:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont, IL 600184262
  Phone: 1-847-8237186
  Web Address: http://www.aaos.org/
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

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