A knee fracture is a severe injury that involves the four bones involved in the formation of this joint. The pathology is widespread among girls and men over the age of 20. Fractures of the knee joint account for approximately 10% of the total number of injuries of the musculoskeletal system.
Kinds
The effectiveness of the prescribed therapy depends on the correct diagnosis and determination of the type of injury. Fractures are:
- Open. They are accompanied by damage to the integrity of the skin.
- Closed. The skin is not injured.
Open knee fractures are associated with a high risk of infection and severe blood loss. The lack of timely first aid can lead to the death of the victim.
© Photographee.eu - stock.adobe.com
Intra-articular knee fractures are:
- with displacement of fragments;
- no offset.
Depending on the position of the parts of the patella, injuries are classified into:
- Osteochondral. A small part of the patella is detached.
- Horizontal. Breaking the bone in two.
- Multiple splinters. The bone is shattered into several pieces.
- Vertical. The cup breaks along.
According to the location of bone fragments along the axis, fractures are:
- With the displacement of the fragments. Surgical intervention is required.
- No bias.
- Compression. The bone is pressed in.
The severity of a displaced injury largely depends on the sprain. If the victim does not have problems with the tendons, shrapnel displacement can be avoided.
Old fractures require longer treatment and rehabilitation than primary fractures.
The reasons
Knee injury is predominantly prone to professional athletes due to the constant intense stress on the knee. This injury is also common among the elderly due to age-related degeneration of the joint tissue.
The main causes of a knee fracture are:
- intense blow to the patella or excessive pressure on the knee joint;
- fall on the lower limb bent at the knee.
Violation of the integrity of the knee can occur due to strong tension of the tendons, provoking a rupture of the muscle and bone apparatus of the patellar region.
© Aksana - stock.adobe.com
Symptoms
The following clinical manifestations are characteristic of a knee fracture:
- severe pain;
- swelling of adjacent tissues;
- hematoma;
- deformation of the knee joint, due to the shift of bones;
- breaks in the skin;
- violation of the functionality of the joint and limitation of movement;
- temperature increase.
Recognition of injury is based on palpation or examination of an X-ray image on which damage is visualized. A few days after the injury, the knee turns blue, and the hematoma spreads to the foot.
This condition is considered normal with a knee fracture; no additional treatment is needed.
Knee injury requires immediate medical attention, as improper treatment can cause serious complications. It is categorically impossible to self-medicate.
© praisaeng - stock.adobe.com
First aid
An injured person with a fractured knee needs qualified medical attention. Therefore, the first task of the surrounding people is the urgent delivery of the patient to the nearest emergency room.
To reduce the risk of possible complications, the patient needs high-quality first aid at the scene:
- With an open fracture, bleeding is stopped with an aseptic bandage and tourniquet. If it is necessary to transport the victim for a long time, the tourniquet is removed every 40 minutes in the winter season and after 90 minutes in the summer.
- When closed: the injured limb is immobilized, a cold compress is applied and fixed with a splint.
Any type of fracture requires high-quality pain relief.
Self-reduction of fragments is strictly prohibited. This action additionally injures the patient and aggravates his situation.
Treatment and rehabilitation
Treatment of knee injuries is the responsibility of an orthopedic surgeon. Therapy can be performed conservatively or surgically, depending on the severity of the injury.
With a closed fracture, plaster is applied for a period of 1.5 to 2 months. If there is an injury to the condyle, a puncture is performed before casting to remove fluid from the articular cavity of the joint. At the same time, anesthesia is performed. A knee joint is used as an alternative to plaster.
The leg is cast in a position with the knee bent inward, about 5-7 degrees. Do not apply a cast on a fully extended lower limb.
If a displaced fracture is detected, the shifted bones are reduced under general anesthesia. After that, a plaster cast is applied.
If the injury is aggravated by rupture of soft tissues and the separation of fragments from the bone, the patient needs surgery.
Doctors restore bones in fragments, collecting them in their original position. Parts of the bones are fastened together with special surgical devices: screws, knitting needles, bolts, steel pins and plates.
The plaster cast is applied after a successful operation. The process of joint restoration depends on the individual characteristics of the human physiology. Healing of the knee joint associated with soft tissue rupture takes much longer than with other types of fractures.
Skeletal traction is an effective treatment. In this case, a tire is applied to the injured limb, a spoke is driven through the heel, to the end of which a load is suspended. After a couple of days, the treatment is supplemented with lateral tension using lateral weights, which are applied to the condyle and lower leg.
Drug therapy is aimed at alleviating the condition of the victim and preventing possible complications. As prescribed by a doctor, the following groups of medicines are used:
- Anesthetics. To relieve pain.
- Antibiotics They help prevent infection of damaged tissues with open injuries.
- Analgesics. Used as concomitant medications until pain relief.
- NSAIDs. They stop the inflammatory process.
© WavebreakMediaMicro - stock.adobe.com
Knee splint
It is an effective alternative to traditional plaster cast. The knee splint has a number of advantages:
- reliable fixation of the knee joint;
- comfortable walking;
- corrective property for limb deformation;
- reducing the load on the leg and ensuring a calm position.
This type of orthosis can be used for various purposes:
- fixing the leg;
- removing the load;
- adjustments for changes in the shape of the leg.
Rehabilitation
The recovery period can vary from person to person. With a mild fracture, a person recovers in 2-3 months. After a severe injury, rehabilitation can take 10 to 12 months.
In order to accelerate healing, the patient is prescribed procedures:
- massage;
- magnetotherapy;
- UHF;
- mud applications;
- salt baths;
- electrophoresis;
- Exercise therapy.
When developing the knee, the load should be increased gradually so as not to provoke repeated injury.
It is recommended to practice leisurely walking and use an exercise bike.
Complications and consequences
After surgery, local and general complications may occur.
Local complications include:
- Infectious lesion.
- Suppuration.
With timely treatment for medical help, they do not pose a threat to human life.
The healing process of the injury is monitored by radiography, which can provoke:
- bursitis;
- arthritis;
- chronic painful syndrome in the knee joint;
- stiffness;
- decreased elasticity of the ligamentous apparatus;
- muscle atrophy.
General complications can lead to cardiovascular disease.
Medical supervision and a complex of treatment and rehabilitation measures can reduce the risk of possible complications and help restore the functions of the knee joint.
