What are the warning signs of a knee fracture?
These injuries involve fracture of the distal femur, patella or proximal tibia. They are usually due to a certain energy mechanism, accidents, blows or contact sport injuries.
Patients present pain and functional impotence, swelling and edema, with impossibility of support or mobilization.
They should be suspected when there is a snapping sensation in the knee, deformity or when there is inability to extend the knee.
What diagnostic tests are needed to confirm the fracture?
The initial test is an X-ray, which is essential to clarify the diagnosis. Two projections are usually sufficient: anterior and lateral. If doubts persist, an oblique projection is performed.
When the bone lesion is not significant, a soft tissue lesion must be suspected. An MRI is often required to rule out ligament and meniscus injury and to assess bone edema.
Initially, the hematoma of the knee can be aspirated to improve pain and confirm the suspicion of intra-articular injury.
The CT scan is the best test to specifically assess the bone, make 3D reconstructions and plan surgery.
What is the most appropriate treatment?
The treatment must be adapted to the patient and to the type of lesion. It will also depend on the fractured bone.
Fractures without displacement can be managed with conservative treatment, without support, with anti-inflammatory drugs, ice and targeted physiotherapy. These will require initial immobilization with a splint or orthosis and must follow an exhaustive radiological control during the first weeks, to rule out secondary displacements.
More complex fractures, affecting the joint, or displaced fractures benefit from surgical treatment to restore anatomy and function.
The techniques used are osteosynthesis techniques, which will allow the bone structure to be recomposed, bring the fragments together and provide stability for healing. These fractures, which affect the joint, are more serious and the joint must be restored to avoid early degeneration.