Knee Fractures and Trauma

What are Knee Fractures and Trauma?

Knee fractures and trauma refer to injuries that affect the bones, cartilage, ligaments, tendons, and other structures surrounding the knee joint. The severity of these injuries can vary, ranging from minor fractures and soft tissue injuries to complex fractures and ligament tears.


Impact of Knee Fractures and Trauma on Anatomy and Health

  • Bone Fractures: Fractures in the knee can involve any of the joint's bones, including the femur (thigh bone), tibia (shin bone), and patella (kneecap). These fractures can disrupt the joint's normal alignment and lead to pain, swelling, and difficulty in movement.
  • Soft Tissue Injuries: Trauma to the knee can damage the soft tissues, including ligaments (such as the anterior cruciate ligament or ACL, posterior cruciate ligament or PCL, and medial and lateral collateral ligaments), tendons, and menisci (cartilage pads). These injuries can cause instability, limited range of motion, and joint stiffness.
  • Impact on Functionality: Knee fractures and trauma can significantly impair mobility and daily activities. Depending on the severity of the injury, individuals may experience difficulty walking, standing, or participating in sports and physical activities.
  • Long-Term Complications: If not properly treated, knee fractures and trauma can lead to long-term complications such as arthritis, chronic pain, and decreased quality of life. Proper diagnosis, treatment, and rehabilitation are essential for minimising these risks.


Risk Factors for Knee Fractures and Trauma

Several factors increase susceptibility to knee injuries:

  • Sports and Physical Activity: Athletes and individuals engaging in high-impact sports face a heightened risk due to the repetitive stress and trauma exerted on the knee joint.
  • Age and Gender: Older adults and females may be more vulnerable, especially those with osteoporosis or weakened bones.
  • Previous Injuries: Individuals with a history of knee injuries are more prone to recurrent trauma and fractures.
  • Occupational Hazards: Jobs involving heavy lifting, repetitive kneeling, or prolonged standing may increase the risk of knee injuries.


Symptoms of Knee Fractures and Trauma

The symptoms of knee fractures and trauma can vary depending on the severity and type of injury but may include:

  • Pain: Persistent or severe pain in the knee, which may worsen with movement or weight-bearing activities.
  • Swelling: Swelling and inflammation around the knee joint, often accompanied by warmth and redness.
  • Bruising: Visible bruising or discolouration around the knee area due to bleeding under the skin from injury.
  • Instability: Feeling of instability or giving way in the knee joint, especially during weight-bearing activities or movements.
  • Limited Range of Motion: Difficulty bending or straightening the knee fully, stiffness, and decreased flexibility.
  • Popping or Grinding Sensation: Sensation of popping, clicking, or grinding within the knee joint, which may indicate damage to the cartilage or other structures.
  • Difficulty Walking: Trouble walking or bearing weight on the affected leg, often accompanied by limping or favouring the uninjured leg.
  • Locking or Catching: Feeling of the knee joint locking or catching during movement, which may indicate a meniscal tear or loose body within the joint.


Types of Knee Fractures and Trauma

Knee fractures and trauma can manifest in various forms, including:

  • Patellar Fractures: Fractures of the kneecap (patella), which can be caused by direct impact or sudden contraction of the quadriceps muscle.
  • Tibial Plateau Fractures: Fractures involving the top surface of the tibia (shinbone), often occurring due to high-energy trauma or compression forces during falls or car accidents.
  • Femoral Condyle Fractures: Fractures of the rounded ends of the femur (thigh bone) that articulate with the tibia, commonly resulting from sports injuries or motor vehicle accidents.
  • Ligament Tears: Injuries to the ligaments supporting the knee joint, such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial and lateral collateral ligaments (MCL and LCL).
  • Meniscal Tears: Tears in the menisci, the cartilage pads that cushion the knee joint, often caused by twisting or sudden pivoting movements.



Diagnosis of Knee Fractures and Trauma

Diagnosing knee fractures and trauma typically involves a combination of clinical evaluation, imaging studies, and diagnostic tests:

  • Physical Examination: Doctors assess the knee for signs of swelling, tenderness, instability, and range of motion limitations. Specialised tests, such as the Lachman or McMurray test, may be performed to evaluate ligament and meniscal injuries.
  • Imaging Studies: X-rays are commonly used to detect fractures and assess the alignment of bones in the knee joint. Advanced imaging modalities, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be utilised to comprehensively evaluate soft tissue injuries and internal structures.
  • Diagnostic Arthroscopy: In some cases, arthroscopic surgery may be performed to directly visualise and assess the extent of knee injuries, particularly ligament tears and meniscal damage. This minimally invasive procedure allows for both diagnosis and treatment simultaneously.


Treatment Options for Knee Fractures and Trauma

Conservative Treatment

  • RICE Protocol: Rest, Ice, Compression, and Elevation help reduce pain, swelling, and inflammation in the acute phase of injury.
  • Immobilisation: Splinting or bracing may be necessary to stabilise the knee and prevent further damage, especially in fractures or ligamentous injuries.
  • Pain Management: Over-the-counter or prescription medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics, can alleviate pain and discomfort.
  • Physical Therapy: Targeted exercises and rehabilitation programs help improve strength, flexibility, and range of motion, facilitating recovery and preventing recurrence.


Surgical Intervention

  • Internal Fixation: Surgical procedures, such as open reduction and internal fixation (ORIF), may be performed to realign and stabilise fractured bones using screws, plates, or rods.
  • Arthroscopic Surgery: Minimally invasive procedures, like arthroscopy, allow for direct visualisation and repair of damaged ligaments, menisci, or cartilage within the knee joint.
  • Ligament Reconstruction: Reconstruction of torn ligaments, such as the ACL or PCL, may be necessary for severe ligamentous injuries to restore stability and function.
  • Cartilage Repair or Transplantation: Techniques such as microfracture, autologous chondrocyte implantation (ACI), or osteochondral transplantation can repair or replace damaged cartilage in the knee.


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