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The patella, or your kneecap, is a small bone located in front of your knee joint—where the thighbone (e.g., femur) and shinbone (e.g., tibia) meet. It protects your knee and connects the muscles in the front of your thigh to your tibia to allow to extend your knee.
Because your patella acts as a shield for your knee joint, it can easily be broken. Falling directly onto your knee, for example, is a common cause of patellar fractures.
Patellar fractures account for roughly 1% of all fractures. They are most common in people who are 20 to 50 years old, and men are twice as likely as women to fracture the kneecap. These fractures are serious injuries and often require surgery to heal.
To help reduce your chance of a patella fracture:
The major symptoms of a patellar fracture include pain and swelling in the front of the knee. Additional symptoms include:
After discussing your symptoms and medical history, your doctor will examine your knee. The edges of the fracture can often be felt through the skin, particularly if the fracture is displaced. Your doctor will also check for hemarthrosis, which is swelling deep inside of the joint that is usually a result of bleeding caused by the fracture. Your doctor may order an X-ray. X-rays create images of dense structures, like bone, so they are particularly useful in showing fractures. Although rare, a person may be born with extra bones in the patella that have not grown together. This is called bipartite patella and may be mistaken for a fracture. X-rays help to identify bipartite patella. Many people have bipartite patella in both knees, so your doctor may take an X-ray of your other knee, as well, to confirm diagnosis. This is an incidental finding and often does not cause people any issues.
If the force of the injury has not displaced the pieces of broken bone, you may not need surgery. Instead, casts or splints may be used to keep your knee straight. This will keep the broken ends in proper position while they heal. On the other hand, if the patella has been pulled apart (displaced), you will most likely need surgery with wires or pins. Fractured patellar bones that are not close together often have difficulty healing or may not heal. The thigh muscles that attach to the top of the patella are very strong and can pull the broken pieces out of place during healing.