KNEE FRACTURE

QUESTIONS AND ANSWERS

Proximal Tibial Fractures:

The shin bone’s uppermost portion, the proximal tibia, is where it expands and joins the knee joint. Depending on the location of the fracture, there are many forms of proximal tibia fractures.

• A proximal tibial fracture refers to a break or fracture of the tibia, the shin bone. Proximal tibial fractures, which take place nearer to the knee joint (proximal), can lead to arthritis and instability by altering the alignment of the legs and creating uneven joint surfaces and defects.
• Tibial shaft fractures frequently cause damage to the soft tissues in the immediate area, including blood vessels, nerves, muscles, and torn skin. Tibial Shaft Fractures occur in the region between the knee and ankle joints.

Patellar Fracture:

The patella, or kneecap, can break and suffer from a patellar fracture. A patella can fracture in a variety of ways, from a little chip to a total shattering of the bone. The following lists the primary forms of patellar fractures:

• Displaced fracture: The bone’s shattered ends appear apart and out of alignment.
• Comminuted fracture: Depending on the pattern of the fracture, the bone breaks into three or more fragments.
• An open fracture occurs when the shattered bone pierces the skin and harms the soft tissue in the vicinity.

What Other Things Might Cause Knee Pain?

Bursitis

A bursa refers to a sac under the skin above the joint that contains a small quantity of fluid. As the joint moves, it lessens friction. The bursa on top of the kneecap might get irritated by overuse, accidents, or frequent bending and kneeling. This causes discomfort and edema.

Dislocated kneecap

The kneecap falls out of place as a result, resulting in knee discomfort and swelling. Doctors will refer to this as “Patellar dislocation”.

Iliotibial band syndrome

From your child’s hip to the outside of the knee, there is a thick band of tissue called the iliotibial (IT) band. It might eventually get inflamed when your child overdoes an activity. The knee’s outside side feels tender as a result. Running downhill often causes it for runners.

Meniscal tear

Occasionally, a knee injury might result in cartilage tearing. These jagged edges may become lodged in the joint, resulting in inflammation and discomfort. When they become active, people frequently experience a “catching” in the joint.

Osgood-Schlatter disease

Young people who still have developing bones and other knee components have this problem. A painful lump might develop where a tendon from the kneecap connects to the shin below the knee. Overdoing activities and inflammation in the tibial tubercle, a spot on the bottom of your knee, usually affect this area. The discomfort could reappear over time. Osgood-Schlatter disease occurs mostly in teenage boys and girls.

Osteoarthritis

Arthritis refers to the “wear and tear” variety. After age 50, doctors see osteoarthritis as the main cause of knee discomfort. When your child is active, this ailment makes the knees have pain or bulge. Early in the day, osteoarthritis-affected joints may also feel stiff.

Patellar tendinitis

Tendons, which refer to hard bands of tissue, attach the muscles to bones. They may swell up and hurt if your child uses them excessively. Because doctors tell us that repetitive jumping appears as the most prevalent cause, you may also hear it referred to as “jumper’s knee.”

Symptoms of Knee Fracture

An injured kneecap frequently hurts right away. However, further signs may include the following:

• Immediate knee bruising and swelling.
• Knee pain in the back.
• Difficulty bending the knee or putting weight on the injured leg.
• A sensation of scraping or grinding while moving.
• Spasms of the muscles.

The shattered bone may, however, occasionally show through the skin. In other situations, the knee has the same appearance as always but performs abnormally.

What Kind of Knee Damage Generates Discomfort Behind the Knee?

Pain behind the knee, generally more on the inside or outside, might result from meniscus or cartilage tears in the knee. These tears are mostly generative in nature. The ‘root’ of the meniscus, where it joins to the center of the knee, does, on occasion, rupture. A doctor may advise rest and ice application if your child has sudden or severe discomfort behind his or her knee. In some circumstances, your doctor could also advise you to elevate your child’s leg while seated to enhance the blood flow in the leg.

Knee Fracture Diagnosis:

A knee fracture may have one of the following common diagnoses:

• An imaging test called computed tomography (CT) scan of your child’s bones creates comprehensive pictures of the damaged knee using X-rays and a computer.
• Using magnets, radio waves, and a computer, magnetic resonance imaging (MRI) creates comprehensive images of the knee to aid in diagnosis.
• Parents can see what sort of break their child has by taking an X-ray of the knee.

Solutions for Treating Broken Bones and Knee Fractures

Depending on the severity of the fracture and your child’s medical history, treating a knee fracture today no longer remains a challenging situation for the doctors at Medical City Children’s Orthopedics and Spine Specialists. For the treatment of knee fractures, both surgical and non-surgical options consist of the following:

Non-Operative

Surgeons will not recommend surgery if a knee fracture appears straightforward and the bones do not move. Instead, to keep your child’s bone in place, your doctor may recommend medications and a cast or splint. Your child will need to refrain from activities or carrying heavy objects during this period.

Operative

The kind of surgery will depend on the kind and severity of your child’s fracture. Your initial meeting with our surgeon will include a thorough discussion of the possible choices. Also, if it appears that broken bone fragments exist or if a large space exists between the fractured pieces to negatively affect healing, surgery will be suggested. If a doctor sees a broken bone exiting the skin because of an open fracture, he will advise immediate surgery. Finally, the kind of procedure that doctors will conduct depends on the kind of fracture that has occurred. While the tiny bone pieces from a comminuted fracture are removed from the knee joint, a transverse fracture is mended with the use of wires, pins, and a tension band in a “figure-of-eight” arrangement.

Internal Fixation

Both femoral and tibial fractures require internal fixation. The surgeon will use Intramedullary rods and screws to hold the bones together after being initially moved into their natural positions.

Intramedullary nailing

If your child has a fractured femur, or if only the upper quarter of the tibia is damaged and the joint is intact, the surgeon inserts a specially designed rod into the medullary canal of the damaged bone.  The surgeon will attach the rod with screws at each end.

Plates and screws

Your surgeon will realign the damaged pieces into their proper positions instead of inserting a rod, and then secure them in place using metal plates and specialized screws.

External fixation

In rare circumstances, the fracture may seriously harm the nearby soft tissues. Thus, in this situation, inserting a rod might endanger the tissue even more. So, the surgeon will stabilize the midpoint of the tibia and femur by inserting pins and metal screws. Then in order to hold your child’s bones in place, screws will attach to an outside bar. In an emergency or when the limb appears severely damaged, doctors will use external fixing. This enables your bone to recover prior to having an internal fixation or knee replacement.

Why choose the Doctors at Medical City Children’s Orthopedics and Spine Specialists

Every year, hundreds of children, teens, and young adults with fractures of all sorts and levels of complexity are treated by the orthopedic and fracture experts at Medical City Children’s Orthopedics and Spine Specialists.  We have offices in Arlington, Dallas, Flower Mound,  Frisco, and McKinney, TX.  Our expertise in children permits precise diagnosis of illnesses affecting the growing musculoskeletal system as well as the development of efficient treatment plans. Orthopedic injuries that require immediate medical attention but are not severe enough to warrant emergency room care are treated by our orthopedic specialists.

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Footnote:

American Academy of Orthopaedic Surgeons: Patella Fracture