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Patellar Fracture in Children

WHAT YOU NEED TO KNOW:

What is a patellar fracture?

A patellar fracture is a break in your child's kneecap. Treatment depends on how the kneecap breaks. Broken pieces may move out of line or break through the skin.

Knee Anatomy

What are the signs and symptoms of a patellar fracture in children?

  • Pain when your child's knee is touched or when he or she moves the leg
  • Swelling and bruising around the knee
  • Not being able to put weight on the leg
  • Not being able to raise the leg when he or she is lying down

How is a patellar fracture in children diagnosed?

Your child's healthcare provider will ask about the injury and examine your child. He or she will look for bone that broke through the skin. He or she may be able to tell if the bone pieces are in their correct places by touching your child's knee. Your child may need any of the following tests:

  • An x-ray may show the kind of fracture your child has. Healthcare providers may also x-ray the other leg to compare kneecaps.
  • A CT scan or an MRI may show a fracture or other injury. Your child may be given contrast liquid to help healthcare providers see his or her kneecap better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
  • A bone scan is used to look at your child's fracture and check for infection. Your child will get a radioactive liquid, called a tracer, through a vein. The tracer collects in your child's bones and pictures are taken.

How is a patellar fracture in children treated?

  • A brace, cast, or splint may be needed. These supportive devices stop the kneecap from moving and help it heal. Your child may also need to use crutches to help him or her move around while the kneecap heals.
  • Medicines can help prevent or fight pain or a bacterial infection. Your child may also need a Td vaccine. This vaccine is a booster shot to help prevent tetanus. He or she may need the Td vaccine if bone broke through the skin.
  • Closed reduction may be used to move the broken pieces back to their correct places without surgery. External fixation may be used to hold your child's kneecap in place, and then removed.
  • Surgery may be used to move the broken pieces back into their correct positions. Wires, pins, screws, or bands may be used to hold the pieces in place. Surgery may also be used to remove part or all of your child's kneecap.
  • Physical therapy may be recommended. A physical therapist teaches your child exercises to help improve movement and strength, and to decrease pain.

What can I do to help my child's patellar fracture heal?

  • Have your child rest his or her knee as directed. Crutches help rest and support your child's knee when he or she walks. Your child's healthcare provider will tell you when your child can start to use crutches. Follow instructions about how much weight your child can put on the leg.
    Walking with Crutches
  • Apply ice to help decrease swelling and pain. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you place it on your child's knee or supportive device. Apply ice for 15 to 20 minutes every hour for 2 days, or as directed.
    Ice and Elevation
  • Elevate your child's knee above the level of his or her heart as often as you can. This will help decrease swelling and pain. Prop your child's leg on pillows or blankets to keep it elevated comfortably. Do not put pillows directly under your child's knee.

When should I seek immediate care?

  • Your child's cast or splint breaks or gets damaged.
  • Your child says that his foot or toes feel numb.
  • Your child's foot or toes are swollen, cold, or turn white or blue.

When should I call my child's doctor?

  • Your child has a fever.
  • Your child's knee pain gets worse, even after treatment.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. 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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Further information

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