What are they ?The term fracture is used by doctors to mean a break in the bone . These breaks may be extremely variable and range from minor and virtually insignificant fractures requiring no active treatment through to devastating injuries which ruin the function and integrity of the joint. Any part of the knee joint may be fractured and isolated breaks of the femur (thigh bone), tibia (leg bone) or patella (knee cap) can occur. Fractures can occur either in the joint and involve the joint surface (intraarticular fractures) or be situated in the bone close to the joint but affect the function of the joint.
How do they occur and how do I know if I have a fracture?
Although fractures can occur without an injury, these are very rare and the majority of fractures occur after a fairly significant injury. A fracture causes sudden acute pain and the knee looses function (it may be painful to weight bear or part of the knee function may suddenly be prevented - for example the knee can not be straightened). In intraarticular fractures there may be sudden and very obvious swelling of the joint.
What will need to be done?
Minor fractures may consist of undisplaced fractures where there is little or no significant change in the normal shape of the bone. These may occur in almost any part of the joint and providing there is little accompanying damage in any other way and assuming that the fracture fragments do not move from the natural anatomical position they may well be treated extremely successfully conservatively (ie with out any operation). Sometimes conservative treatment may require a plaster of paris cast to hold the fracture fragments in place though other methods of stabilization such as a brace (a plaster cast with a hinge around the knee allowing movement at the knee joint but maintaining stability of the joint) may be used.
Major fractures of the knee may result in the complete disruption of the joint surfaces and the natural shape of the bony outline of the knee. The vast majority of these fractures will require placing back where they belong and then fixing with some method in order to keep them from falling out of line again. Complex fractures of the joint (particularly involving the joint surface itself) may require delicate reconstruction and a careful rehabilitation period afterwards. These are generally complex and each operation is often tailored to suit the individual and their injury. The rehabilitation is also suitably designed but as a general rule the fracture around the joint will take 5 to 6 weeks to heal and then a further 6 weeks to rehabilitate.
Some of the more unusual ligament injuries may be accompanied by a fracture. Often these fractures will consist of the ligament and its bony attatchment, which breaks off at the time of the ligament injury. These ligament injuries are frequently best repaired by fixing the bone "stub" of the ligament back to where it belongs.
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