Patellar Fracture Repair

WHAT YOU SHOULD KNOW:

Patellar Fracture Repair (Inpatient Care) Care Guide

A patellar fracture repair is surgery to repair a fractured and displaced patella.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may get an infection in your kneecap or the tissue around it. In some cases, the infection may spread to your knee joint and cause pain and swelling. The hardware in your knee may break or come loose. You may have stiffness in your knee after your kneecap has healed. Scar tissue may form on and under your skin where you had surgery. As scar tissue forms, it may stick together, causing adhesions. These adhesions may limit movement and cause a longer recovery time.

  • You may have less motion and strength in your knee after a patellectomy. Your thigh muscle may be weak, and you may have trouble climbing stairs. You may have posttraumatic arthritis after a partial patellectomy. This is a form of joint swelling caused by the injury and surgery. You may have a nonunion of your kneecap. A nonunion is when the bones do not heal properly after a fracture. Nonunion may be caused by too much movement or an infection after surgery. You may need the same surgery again or a different type of surgery to repair your kneecap. Even after surgery, you may still have pain and other signs and symptoms.

  • You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening. If you do not have surgery, the pain and problems you have may worsen. Your knee may get weak, or you may have problems walking.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your surgery will be done, and then you are moved to a table or bed.

  • Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best for you. You may have one of the following:

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During your surgery:

  • A cuff called a tourniquet will be wrapped around your upper leg to help decrease blood loss. Caregivers may irrigate and debride your knee if you have an open wound over your kneecap. This means that caregivers will carefully clean your knee and remove any foreign objects, such as rocks. Caregivers may do an arthroscopic reduction and fixation. This is when an arthroscope (thin tube with a camera at the end) is used to see inside your knee. The arthroscope and other small tools are put through small incisions over your kneecap. Caregivers may do an open reduction and fixation. This is when a larger cut is made over your kneecap. A reduction and fixation is when the fractured pieces of your kneecap are put back into their correct places. Your caregivers may use hardware, such as wires, screws, or other materials, to hold the pieces together.

  • Caregivers may do a partial or total patellectomy. This is when caregivers remove part, or all, of your kneecap. You may need a patellectomy if your kneecap is shattered into many small pieces. If caregivers do a partial patellectomy, they may do a reduction and fixation on the other pieces. If the tendons or ligaments (connecting tissues) around your knee are damaged, they may be repaired.

  • You may have x-rays done during and after surgery to check your kneecap. X-rays will also show if the hardware or other materials are positioned correctly. If you have a periprosthetic patellar fracture, your knee hardware may need to be removed or replaced. At the end of surgery, the cuts are closed with stitches. A drain may be placed near the incision to remove excess blood and fluids. Your cuts will be covered with bandages.

After your surgery:

You are taken to a room where you can rest. You will have a splint, brace, or cast on your knee. This will protect the kneecap and stop it from moving while it heals. Caregivers will check on you often. A caregiver may remove the bandage soon after your surgery to check the area. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are ready, you may be allowed to go home. If you are staying in the hospital, you will be taken to your room.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

  • Activity: Follow your caregiver's instructions about knee movement after surgery. This is very important because it may help prevent displacing your kneecap or other problems after surgery. Caregivers may teach you special exercises to strengthen your upper leg muscles.

  • Continuous passive motion: Continuous passive motion (CPM) is a machine that gently bends and extends your knee for you. CPM may decrease pain and stiffness in your knee after surgery.

  • Crutches or a cane: You may not be able to use your leg to walk right after surgery. You may need to use crutches or a cane to walk after surgery. These devices may help support your knee when walking and may decrease your chance of falling. Ask your caregiver for more information about how to use crutches or a cane.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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