Treating Patella Fracture
Overstressing patella fractures too soon could hinder the healing process
PTs face many unique challenges when treating a variety of orthopedic patients. To effectively manage orthopedic injuries, PTs must be knowledgeable of musculoskeletal tissue healing principles, be familiar with various rehabilitation programs, know how to skillfully apply rehabilitation techniques as well as fundamentally understand common and uncommon soft tissue injuries, fractures and diseases of muscles, bones and joints. Management of patella fractures, both nonoperative and postoperative, provides PTs with an opportunity to fully utilize each component of effective rehabilitation.
Causes and Types
Fractures of the patella most commonly occur from direct trauma, usually a fall on the knee or a direct blow to the patella. Less frequently, the patella can be fractured by a sudden, violent contraction of the quadriceps.
Patella fractures are classified as either transverse, stellate or vertical. These three categories can be further classified as displaced or nondisplaced. The arterial blood supply to the patella is derived from two systems of vessels from branches of the geniculate arteries. These two systems supply the middle third and apex of the patella. In cases of displaced transverse fractures, the proximal blood supply may be compromised leading to avascular necrosis of the proximal segment.
Overall, the management of patella fractures is based on classification and morphology of the injury. Treatment options range from nonoperative to operative with open reduction and internal fixation to partial or total patellectomy.