• Dr. Sunil Dachepalli

Fractures Around knee

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Description:

Knee joins thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation.

Types of Fractures:

There are three types of fractures based on the pattern of the fracture:

1.Fractures of thigh bone:

THIGH BONE FRACTURE

2. Fractures of leg bone:

LEG BONE FRACTURE

Treatment:

Immediate management includes ice pack application and limb elevation with a pillow.

Ice pack application

Limb elevation

Definitive management is decided by fracture type whether its displaced or undisplaced.

Undisplaced Fracture:

  1. Groin to toe plaster/Long knee brace for 6 to 12 weeks. Cast could be replaced with a knee brace after some period based on the fracture healing.

Plaster of paris for undisplaced fracture

Long knee brace

  1. During cast treatment it is essential to repeat an x-ray for 10 to 15 days.

Displaced Fracture:

  1. Treated surgically.

  2. Displaced fractures are treated with plates and screws.

X-Ray showing open reduction internal fixation

Screw fixation

Recovery:

After surgery patients will be advised not to bear weight on the operated leg for atleast 4-6 weeks, followed by partial weight bearing and full weight bearing walking, depending upon the healing.

Non weight bearing is allowed with a shoe rise on normal side.

Picture showing shoe rise

3. Patella Fracture:

A patellar fracture is a break in the patella or knee cap, the small bone that sits at the front of the knee.

Patella fracture

Symptoms:

  1. Inability to straighten the knee joint.

Management:

Non-surgical:

  1. Surgery is not required in an undisplaced fracture. Cast or splint is applied to keep the knee straight.

  2. In some fractures weight bearing is allowed with the help of brace or cast.

  3. In some fractures weight bearing is not allowed for 6 to 8 weeks.

Surgical:

Displaced fractures needs surgery

X-Ray showing tension band wiring

Patella Plate

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