Patella fracture: treatment and rehabilitation
A fracture of the patella is rare - it accounts for 1.5% of all traumatic fractures. It is more often diagnosed in the elderly, mainly as a result of a banal street injury. Treatment and recovery after a patellar fracture is carried out only under the supervision of a doctor.
Classification and description
There are several types of this injury:
- closed fracture of the patella - there is damage to the bone, but it does not communicate with the external environment;
- open - in this case, there is a connection between the fracture site and the external environment.
Depending on the projection in which the patella fracture occurred, it can be longitudinal or transverse.
A fragmental fracture of the patella is determined if bone fragments are formed at the fracture site.
In addition, a fracture of the patella with displacement is distinguished - this diagnosis is made if the bone fragments have shifted after the fracture of the patella.
Symptoms
As a rule, this type of injury occurs after a person falls on the patella and can be accompanied by tendon rupture. The presence of a patellar fracture is indicated by:
- pronounced swelling of soft tissues in the area of the patella;
- severe pains when probing the place of injury;
- the presence of a gap in the knee joint that can be felt during palpation;
- accumulation of blood (a soft mass with unclear boundaries is palpable);
- often – pathological mobility of the knee and clearly defined bone crunch.
If a patella fracture occurred without displacement, the victim can walk, but at the same time he will limp and feel severe pain. Even a slight displacement of bone fragments leads to the fact that the joint will not bend.
Treatment and rehabilitation after patella fracture
Treatment of patella fracture can be conservative and surgical. If the injury occurred without displacement and the fracture is closed, the doctor will apply a posterior plaster cast for 15-20 days. At the same time, the patient is allowed to walk, but only on crutches. Rehabilitation after a patellar fracture should be started immediately after applying a cast - this includes magnetic therapy, laser treatment, physical therapy and massage. As a rule, full working capacity is restored after 2 months.
If there was a fracture with displacement and the fragments moved from the place of injury by 0.5 cm or more, then this is a direct indication for surgery. The Berge-Schultze method is most often used: after comparing all the fragments, muscle and tendon plastic surgery is performed. Surgery for a patellar fracture ends with a plaster cast and immobilization of the injured limb for at least 30 days. If the fracture is multifragmentary, then in some cases doctors have to remove the fragments during the operation - then the integrity and functionality of the patella cannot be preserved.
Recovery after a patella fracture lasts at least 3 months. For the first 30 days, the patient is in a supine position, he is rarely allowed to get up, he can move only on crutches. After removal of the plaster cast, the patient must undergo rehabilitation - the following are involved:
- therapeutic exercise and massage aimed at restoring the function of the knee joint;
- physiotherapeutic procedures - action with weak currents and others.
The results of rehabilitation after a patellar fracture depend on the regularity and correctness of all procedures. Doctors do not recommend completely avoiding stress on the injured leg - in the process of restoring the limb, the patient should perform physical exercises and develop the knee joint.
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