Patellar Fractures: Recovery Tips and Pain Management

Patellar fracture

Hello Doctor: I accidentally fell on February 5th and my left knee hit the ground directly.
Initially, it was fine, but after 2 to 3 hours, it started to swell and hurt when I straightened or bent my knee.
I started icing it at home.
After two days of icing, the swelling mostly went down, and there was less pain when straightening or bending my knee.
I could walk without pain, but the bruising had not yet faded.
On February 10th, while going up and down stairs, I noticed that bending my left knee to support my body weight caused significant pain.
So, I went to see a doctor and had an X-ray.
It revealed two cracks at the lower edge of the patella.
The doctor did not provide any immobilization but advised me to avoid strenuous activities to prevent a complete fracture of the patella and lent me crutches.
I would like to ask: 1) Do I need to use crutches to walk? Because I can walk normally without pain, and I am worried that using crutches might cause me to fall again, as they are difficult to use.
2) My workplace only has stairs and no elevator, three stories high.
Can I go up the stairs slowly using only my right leg without crutches? My left leg does not hurt at all as long as it is not bearing weight when bent.
3) Would wearing a compression knee brace be helpful?

Cindy, 30~39 year old female. Ask Date: 2021/02/11

Dr. Chen Bochen reply Orthopedics

1-2.
It is recommended to use a cane; if improper weight-bearing leads to a fracture separation, surgery may be required, which would be counterproductive.
3.
Using a knee brace can be beneficial.

Reply Date: 2021/02/11

More Info

Understanding patellar fractures and their recovery process is crucial for ensuring a successful rehabilitation and pain management strategy. Based on your description, it seems you have sustained a minor fracture in your patella, which is the kneecap, and while you are experiencing some pain and swelling, it appears that you are on the right track with your initial management.

1. Use of Crutches
Using crutches is often recommended after a knee injury, even if you feel you can walk without pain. The primary purpose of crutches is to reduce the weight and stress on the injured knee, allowing it to heal properly. While you may feel comfortable walking without them, using crutches can help prevent further injury, especially if you accidentally put too much weight on your left leg. If you find crutches challenging and fear falling, consider discussing this with your doctor or physical therapist. They may suggest a gradual transition away from crutches as your knee heals.

2. Navigating Stairs
When it comes to navigating stairs, it is generally advisable to avoid putting weight on the injured leg until you receive further guidance from your healthcare provider. If you can ascend the stairs using only your right leg and feel stable doing so, it may be acceptable in the short term. However, be cautious and listen to your body. If you experience any pain or discomfort while doing this, it would be wise to reconsider and use crutches or seek assistance. Always prioritize safety, especially when dealing with a knee injury.

3. Wearing a Compression Knee Brace
Wearing a compression knee brace can be beneficial for several reasons. It can provide support to the knee joint, help reduce swelling, and offer a sense of stability as you move. Compression can also improve blood circulation in the area, which may aid in the healing process. However, ensure that the brace fits properly and does not cause any discomfort or restrict blood flow. If you experience any adverse effects, consult your healthcare provider.

Additional Recovery Tips
- Rest and Ice: Continue to rest your knee and apply ice to reduce swelling, especially after activities that may aggravate the injury.

- Gentle Range of Motion Exercises: Once the swelling decreases, gentle range of motion exercises can help maintain flexibility in the knee. Avoid any movements that cause pain.

- Gradual Return to Activity: As you heal, gradually reintroduce activities. Listen to your body and avoid any high-impact exercises until cleared by your doctor.

- Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage pain and inflammation. However, consult your doctor before taking any medication, especially if you have underlying health conditions.

- Follow-Up Appointments: Keep all follow-up appointments with your healthcare provider to monitor the healing process and adjust your treatment plan as necessary.

Conclusion
Patellar fractures can be concerning, but with proper care and attention, most individuals can expect a full recovery. It is essential to follow your doctor's advice, use assistive devices as needed, and engage in rehabilitation exercises when appropriate. If you have any concerns about your recovery or experience increased pain, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and safety should always come first.

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