Patellar Fractures: Recovery Tips and Exercise Guidance

Q: Patellar Fractures: Recovery Tips and Exercise Guidance

Hello： Each person's condition before the injury is different, but generally, a fracture requires immobilization for at least 6 weeks. <br>Since your fracture is an incomplete fracture, the immobilization period may be slightly shorter; please follow your attending physician's in

Patellar fracture issues?

Hello, doctor.
Over two weeks ago, I fell and fractured my left patella.
The X-ray showed a transverse crack, approximately 2/3 deep, but it is not a complete fracture.
Therefore, my attending physician advised me to use a brace to keep it immobilized at 0 degrees.
During today's follow-up appointment, it was confirmed that there is no displacement, and I asked the doctor if I could apply heat, perform isometric muscle exercises, and raise my leg.

1.
After returning home, I tried lying flat and raising my leg, but I felt no strength at all.
Afterward, my knee occasionally has a sharp pain.
Is it okay to continue doing this?
2.
Additionally, I saw on the board that I should avoid active extension (including when suspended).
Could you explain what active extension means?
3.
Since I cannot lift my left leg due to weakness, I can only use crutches to move by swinging forward, which causes temporary suspension.
Could this be related?
4.
Do you have any other suggestions? Thank you very much.

BBH, 30~39 year old female. Ask Date: 2020/04/27

Dr. Li Wenhong reply Orthopedics

Hello: Each person's condition before the injury is different, but generally, a fracture requires immobilization for at least 6 weeks.
Since your fracture is an incomplete fracture, the immobilization period may be slightly shorter; please follow your attending physician's instructions.
1.
If you occasionally experience sharp pain, continue your activities but reduce the intensity.
After 1-2 weeks, you can gradually increase the intensity and discuss it with your attending physician during your follow-up visit.
2.
You should focus on active stretching (contracting the quadriceps to straighten the bent knee joint to 0 degrees), but since the fracture has not healed, this should be avoided.
3.
It's okay.
Just avoid intentionally bending or extending the knee joint.
4.
Regularly follow up with your attending physician for discussions.
Changhua Hospital, Orthopedics, Dr.
Li Wen-Hong.

Reply Date: 2020/04/27

More Info

Understanding patellar fractures and their recovery process is crucial for ensuring a successful rehabilitation. A patellar fracture, especially one that is not displaced, can often heal well with conservative management, including immobilization and physical therapy. Here are some insights and recommendations based on your questions and the general principles of rehabilitation for patellar fractures.

1. Continued Exercise with Discomfort: It’s common to experience some discomfort or pain during rehabilitation exercises, especially after a recent injury like a patellar fracture. If you are attempting to perform straight leg raises and feel a lack of strength or occasional sharp pain, it’s essential to listen to your body. Mild discomfort can be expected, but sharp pain is a signal to stop. You should continue with gentle isometric exercises as advised by your physician, focusing on engaging the quadriceps without causing pain. If the pain persists or worsens, consult your healthcare provider for further evaluation.

2. Understanding Active Extension: Active extension refers to the movement where you actively straighten your knee against gravity. This can be challenging after a patellar fracture, especially if there is weakness or pain. Avoiding active extension means you should not forcefully try to straighten your knee while it is unsupported, as this can put undue stress on the healing bone and surrounding tissues. Instead, focus on passive movements or gentle stretches that do not cause pain.

3. Using Crutches and Weight-Bearing: Using crutches to assist with mobility is a common practice after a knee injury. However, if you are experiencing a "swinging" motion while using crutches, ensure that you are using them correctly to avoid putting excessive strain on your knee. The goal is to minimize weight-bearing on the injured leg while maintaining mobility. If you feel that your knee is experiencing too much strain during this process, consider consulting a physical therapist who can provide guidance on proper gait mechanics and crutch use.

4. Additional Recommendations:
- Physical Therapy: Engaging in a structured physical therapy program can significantly aid your recovery. A physical therapist can provide tailored exercises that focus on strengthening the quadriceps, improving range of motion, and enhancing stability without risking further injury.

- Ice and Heat Therapy: Continue using ice to manage swelling and pain, especially after exercises. Heat can be beneficial before exercises to warm up the muscles, but be cautious not to apply heat if there is swelling.

- Gradual Progression: As your strength improves, gradually increase the intensity and complexity of your exercises. This may include moving from isometric exercises to more dynamic movements as tolerated.

- Patellar Brace: Consider using a patellar brace or support during your rehabilitation to provide stability and confidence while moving.

In summary, recovery from a patellar fracture requires patience and adherence to a rehabilitation program that prioritizes safety and gradual progression. Always communicate with your healthcare team about your symptoms and progress to ensure that your recovery is on track. With time and appropriate care, you can expect to regain strength and function in your knee.

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