The patella, or kneecap, forms a tough, bony lid over your knee joint. Children under 15 only account for 1 percent of all patella fractures, according to "Skeletal Injury in the Child" by John Anthony Ogden. The average age for patella fractures in a child is 12.4, an age when children tend to get into more sports and vigorous activities. Many injuries are "sleeve fractures," a type that occurs only in children.
Patella
The patella is a compact piece of bone that's difficult to break through general everyday activities. Tendons connect the kneecap to the upper and lower leg bones. In some cases, a fractured patella occurs when the tendons shear off from the bone due to extreme force. A patella fracture in a child is often the result of a direct blow to the knee. For example, this could happen during a sports game, such as soccer, or when falling from a tree. Some patella fractures happen as a result of motor accidents when a child is hit on the knee or lands on the kneecaps.
Symptoms
Patella fractures cause a lot of pain, so your child will likely be crying hard if he has a broken kneecap. In particular, any movement of the knee in any direction may cause a sudden rush of pain. The knee usually swells or looks differently shaped than the other knee, making it easier to diagnose without causing further pain. Your child almost certainly won't be able to walk on the affected leg. However, in cases where the fracture is very minor it may not be obvious that the knee is broken. This is sometimes the case with sleeve fractures.
Sleeve Fracture
As well as patella fractures from direct blows, another form of patella fracture occurs only in children. Sleeve fractures of the patella happen in children when the leg muscles pull a small bone fragment off the patella while the knee is in use, usually during sports. This makes the knee buckle and causes pain. A sleeve fracture sometimes only involves tiny pieces of bone, so X-rays may not reveal the problem. Minor sleeve fractures often don't require surgery.
Treatment
You should take a child with a suspected kneecap fracture straight to the emergency room. A doctor will likely use X-rays to determine the extent of the damage. A fractured patella in a child may require surgery. Following this, a special cast will encase the knee and keep it from moving for several weeks. Physical therapists help to get the joint moving properly again during the healing process and may ask your child to use crutches for a spell, according to Drugs.com. With the right treatment, outcomes are often positive.
References
- "Skeletal Injury in the Child"; John Anthony Ogden; 2000
- "Acta Ortopaedica Belgica"; Fractures of the Patella in Children and Adolescents; H. Schmal, et al.; OCtober 2010
- Cedars-Sinai: Fractured Kneecap
- "Journal of Orthopaedic Surgery"; Sleeve Fracture of the Patella in Children; G. X. Gao, et al.; 2008
- Drugs.com: Patellar Fracture in Children
