Kneecap (Patellar) Fracture

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KEY POINTS

• A kneecap fracture is a break or crack in the kneecap.
• Treatment may medicine, physical therapy, a brace, or sometimes surgery.
• To help prevent injury, your child should wear protective equipment that fits properly when playing sports, and stretch before and after physical activity.

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What is a kneecap fracture?

A kneecap fracture is a break or crack in the kneecap (patella). It may be just a small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

A kneecap fracture is also called a patellar fracture.

What is the cause?

A broken kneecap usually results from a fall onto the knee or a direct hit to the knee. Some kneecap fractures can happen when your child is jumping or running.

What are the symptoms?

Symptoms may include:

• A snapping or popping sound at the time of the injury
• Pain, swelling, bruising, or tenderness that happens right after the injury
• Trouble walking or straightening the leg

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Tests may include X-rays or other scans.

How is it treated?

The treatment depends on the type of fracture.

• If your child has an open wound with the fracture, he may need treatment to control bleeding or prevent infection.
• Your child may need surgery to:
  • Remove all small fragments of bone
  • Wire the kneecap fragments together, if possible
  • Remove the kneecap if it has shattered
• Your child’s leg may be put in a brace, splint, knee immobilizer, or cast to keep his knee from moving while it heals. Your child should use crutches or a cane as directed by the healthcare provider.

Your child’s healthcare provider may prescribe pain medicine.

With treatment, the fracture may take 6 to 8 weeks to heal. Your child may need to do special exercises to help his leg get stronger and more flexible. Ask your child’s healthcare provider about this.

How can I take care of my child?

Follow the full course of treatment your healthcare provider prescribes.

To keep swelling down and help relieve pain:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for 3 days after the injury.
• When your child sits or lies down, he should keep the injured leg up on pillows so that it is above the level of the heart. Keep the knee straight.
• Give your child pain medicine as directed by your healthcare provider.

Ask your healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• What activities your child should avoid and when he can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a kneecap fracture?

Most broken kneecaps are caused by accidents that are not easy to prevent. However, to help prevent injury, make sure that your child:

• Wears shoes that fit well and give good support.
• Gently stretches before and after physical activity.
• Wears protective equipment that fits properly if he plays sports.