Comminuted fracture

A fracture is called a comminuted fracture when there are more than one fracture lines resulting in more than two bone fragments in the fractured bone. High forces and even normal forces produce comminuted fracture in very fragile bones. There may be splintering of the bone ends and reconstitution of the bone is nearly impossible or difficult. A comminuted fracture occurs in cases where there is direct trauma.

Patella Fracture

A break in the kneecap is known as a fracture of the patella. A fall from a height, a direct blow to the knee and indirect stress are some of the frequent causes of patella fractures. Severe pain, swelling, tenderness and difficulty in straightening the knee are some of the common symptoms associated with patella fracture. Fracture of the patella is also known as kneecap fracture, broken knee, knee fracture and broken patella.

Causes of a Patella Fracture

• Direct force on the patella can result in fracturing the patella.
  
• A fall from a height or a hit to the knee which is very common in contact sports.
  
• During an automobile accident, when a knee that is bent hits against the dashboard and can lead to a patella fracture.
  
• Indirect stress is one reason that can cause patella fracture.
  
• Twisting of the leg.
  
• Muscle contraction that is violent.
  
• Calcium deficiency due to poor nutrition.
  
• Persons who are obese are more prone to this kind of fracture if they suffer a fall.
  
• Joint diseases such as osteoporosis or bone diseases increase the risk of fracture of this kind.

Severe pain and swelling at the area of the fracture is noticed when a person fractures his patella. It will be difficult to move the leg either forward or backward or extend it. There may be swelling and tenderness around the kneecap along with catching or locking of the knee. If bone fragments split enough to bend or twist normal knee contours, deformity of the knee will be apparent. The patient may experience numbness and chill that extends beyond the site of the fracture, if the blood supply at the site gets affected. In a compound fracture or open fracture, the skin is broken by the bone in extreme cases. Immediate attention should be given to this open fracture to avoid infection. The fracture of the patella is classified into three different types.

• As a result of a direct blow an undisplaced fracture of the patella may occur
  
• A direct blow to the front of the knee or a fall can cause a stellate or comminuted fracture. Compromised anterior skin and subcutaneous tissue may be associated with this type of fracture which may be the result of a direct trauma.
  
• The third type is a transverse fracture where there is a gap between the fragments. There is possibility for this fracture when there is a forced, passive flexion of the knee joint is associated with a contraction of the knee joint extenders or the quadriceps muscles.
  

There should not be any delay in realigning the broken bones to reduce the shock. To determine if the patient has suffered a fracture the physician will request for x-rays and stress films after he examines the knee. To immobilize the fracture site, the physician may realign the broken bones and place the knee in a cast or splint only if the fragments of bones are lined up well. Surgery is the other option to remove broken pieces of the knee. A person who has suffered a patella fracture is more prone to knee problems in the future.