Patella Fractures: Recovery, Surgery, and Rehabilitation

Patellar fracture caused by a car accident?

Hello, Doctor! In September of this year, I unfortunately had a car accident that resulted in a patellar fracture.
Initially, it was a hairline fracture, and the emergency doctor applied a cast, stating that surgery was not necessary and that I should wait for the bone to heal on its own.
After using the cast for 5 days, I switched to a self-paid brace (the doctor mentioned that the angle could be adjusted to 30 degrees).
However, three weeks later, during a follow-up X-ray, it was discovered that the bone had shifted (the doctor said surgery could be considered, possibly due to the pulling of the quadriceps and patellar tendons).
Sometimes, I feel involuntary movements in the thigh muscles.
I later opted for surgery, where the doctor used a tension band to stabilize the fracture, as my fracture was close to the inferior edge of the patella.
Since the surgery in mid-October, the doctor has recommended maintaining a 30-degree angle.
I would like to ask the doctor the following questions:
1.
When does the patella start to form callus, can it be seen on an X-ray? Will there be white areas on the X-ray indicating that healing is occurring?
2.
How long does it typically take for the patella to heal enough to return to normal activities?
3.
Is rehabilitation limited to walking and increasing knee flexion?
4.
Will there be any long-term consequences, as I enjoy sports (running and hiking)?
5.
Is it necessary to surgically remove the tension band? If it can be absorbed, how long does the body take to absorb it? The surgeon mentioned that it is tied to the patellar tendon; could this cause tendon injury?
Thank you for your patience in answering my questions.

Nono, 20~29 year old female. Ask Date: 2021/11/30

Dr. Shi Guozheng reply Orthopedics

1.
It is usually noticeable.

2.
Approximately three months.

3.
The knee joint should not be excessively flexed.

4.
It usually does not.

5.
It can also be left in place; it only needs to be removed if it interferes with the movement of the knee joint.

Reply Date: 2021/11/30

More Info

Understanding patella fractures, especially in the context of recovery, surgery, and rehabilitation, is crucial for anyone who has experienced such an injury. Your situation, involving a patella fracture from a car accident, is not uncommon, and many patients face similar challenges during their recovery journey.

1. Bone Healing and X-ray Indicators: When a fracture begins to heal, the formation of a callus, or bone callus, can indeed be observed on X-rays. This callus appears as a white area surrounding the fracture site, indicating that new bone is forming. Typically, the healing process can be monitored through follow-up X-rays, which will show changes in the fracture line and the development of the callus over time.

2. Timeline for Recovery: The time it takes for a patella fracture to heal can vary significantly based on several factors, including the severity of the fracture, the treatment method (conservative vs. surgical), and individual healing rates. Generally, for a non-displaced fracture treated conservatively, healing may take around 6 to 8 weeks. However, since you underwent surgery, it may take a bit longer, potentially up to 12 weeks or more, before you can return to normal activities. Full recovery, including regaining strength and range of motion, may take several months.

3. Rehabilitation Activities: Rehabilitation after a patella fracture typically involves a combination of walking, range of motion exercises, and strength training. Initially, the focus will be on gentle movements to regain flexibility and prevent stiffness. As healing progresses, more intensive exercises will be introduced to strengthen the quadriceps and surrounding muscles. Physical therapy is essential in this phase to ensure a safe and effective recovery.

4. Potential for Long-term Effects: While many individuals recover fully from a patella fracture, there is a possibility of long-term effects, particularly if the fracture was severe or if there were complications during healing. Some patients may experience residual pain, stiffness, or decreased range of motion. However, with proper rehabilitation and adherence to your physical therapy regimen, many athletes return to their previous levels of activity, including running and hiking.

5. Surgical Hardware Considerations: The use of absorbable sutures or fixation devices, such as the wire you mentioned, is common in patella surgeries. If the hardware is absorbable, it will typically be broken down by the body over time, usually within a few months. However, if it is non-absorbable, your surgeon will discuss whether it needs to be removed later. The presence of hardware should not inherently cause damage to the patellar tendon, but any discomfort or unusual symptoms should be reported to your physician.

In summary, recovery from a patella fracture involves careful monitoring of healing through X-rays, a structured rehabilitation program focusing on mobility and strength, and an understanding of the potential long-term implications of the injury. It is essential to maintain open communication with your healthcare team throughout this process to address any concerns and ensure a successful return to your active lifestyle.

Similar Q&A

Managing Pain and Swelling After Patellar Fracture Rehabilitation

I had a car accident on September 15, resulting in a right clavicle fracture and a left patellar fracture. I would like to ask about the rehabilitation; the doctor said I could do it at home. However, after almost a month of rehabilitation, I can only bend my knee to nearly 90 de...

Dr. Shi Guozheng reply Orthopedics
Patellar fractures, if not treated surgically, typically take about three months to heal. After approximately one month, achieving a range of motion up to 90 degrees is reasonable, and it can be gradually increased. For pain relief, analgesics can be taken, and alternating hot an...

Understanding Patellar Fractures: Recovery, Rehabilitation, and Complications

Dr. You Dianqi reply Orthopedics
Hello, I would like to clarify that responses on the internet, without direct patient contact, should primarily rely on the opinions of the operating surgeon. If misunderstandings arise in the doctor-patient relationship due to online responses, it is not the intended purpose of ...

Effective Rehabilitation Strategies After Patellar Fracture Recovery

Hello, Director Chen! I injured my left knee patella due to a fall and had it in a cast for 6 weeks. After the cast is removed, what would be the best way to rehabilitate? Thank you!

Dr. Chen Xianchang reply Rehabilitation
1. If the wound is not healed, laser and ultrasound therapy (from the outside) can be used initially, along with strengthening exercises for the thigh muscles. 2. Once the wound has healed, hydrotherapy can be added to improve flexibility, gradually increasing weight-bearing on t...

Recovery Timeline and Considerations for Patellar Fractures

I have a large open wound on my knee due to a car accident, and I have a comminuted fracture of the patella with one-third removed and two-thirds preserved without the use of steel pins. How long will it take for the bone to heal? How long will rehabilitation take? Will there be ...

Dr. Shi Guozheng reply Orthopedics
The approximate healing time is three months, with rehabilitation lasting three to six months. There is a possibility of degenerative joint changes between the patella and femur in the future. Before complete healing, the knee joint should not be flexed excessively.