Kneecap Fracture
What Is a Kneecap Fracture?
The kneecap (patella) is a small, triangular bone that sits at the front of the knee, embedded within the tendon that connects the quadriceps muscle to the shinbone. It protects the front of the knee joint and helps the quadriceps muscle work more efficiently when straightening the leg. A kneecap fracture is a break in this bone, ranging from a simple hairline crack to a fragment shattered into several pieces.
What Causes a Kneecap Fracture?
- A direct fall onto the front of the knee
- A direct blow, such as the knee striking a dashboard in a car accident
- A sudden, forceful contraction of the quadriceps muscle against resistance, which can pull the kneecap apart (an avulsion-type fracture)
What Are the Symptoms of a Kneecap Fracture
- Immediate, significant pain at the front of the knee
- Swelling, often rapid and pronounced
- Difficulty or inability to straighten the knee on your own
- Inability to bear weight comfortably on the leg
- Visible deformity in more severe or displaced fractures
- Tenderness directly over the kneecap
Can You Straighten Your Leg With a Broken Kneecap?
This is one of the most important questions when evaluating a kneecap fracture. If the fracture separates the kneecap into pieces that pull apart from one another (a “displaced” fracture), the connection between the quadriceps muscle and the shinbone is disrupted, and a patient will typically be unable to actively straighten the leg or perform a straight-leg raise. This finding often points toward the need for surgery to restore that connection. If the fracture is not displaced and the extensor mechanism remains intact, most patients can still straighten the leg, even though it’s painful to do so.
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Treatment Options for a Kneecap Fracture
Nonsurgical treatment is appropriate for fractures that are not displaced (the pieces remain in good alignment) and for patients who can still straighten the leg. This typically involves a period of bracing with the knee kept straight, followed by a gradual, supervised return to bending the knee.
Surgery is generally needed for displaced fractures, fractures where the patient cannot straighten the leg, or fractures involving the joint surface where the pieces need to be precisely realigned. Surgical repair typically involves reconnecting the fragments using pins, wires, or screws to restore the kneecap’s shape and the function of the quadriceps mechanism, followed by a structured rehabilitation program to regain motion and strength.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.