In the blink of an eye, a bad fall can lead to traumatic injury. This is what happened to Dante when he was four-wheeling with his brother, Langdon, and fractured his kneecap.
Fortunately for Dante and Langdon, Obi O. Adigeweme, M.D., specializes in hip and knee surgeries and orthopaedic trauma. He was able to perform minimally invasive outpatient open reduction and internal fixation of the left patella on Dante, a surgery designed to get him back on his feet.
Looking back on their experience, Langdon thanks Dr. Adigweme and Orlando Orthopaedic Center for taking care of his brother at a time when they weren’t even sure it could be done in time before further damage was caused. Throughout their time at Orlando Orthopaedic Center, Langdon says he and Dante were “very impressed with how [Dr. Adigweme] wanted to listen to what we had to say,” calling Dr. Adigweme “easy to communicate with.”
He also says, “This was the difference we found at Orlando Orthopaedic Center. They were immediately involved, immediately scheduling, and number one, above almost everything, [returning] calls quickly.”
Because of the rapid involvement of Dr. Adigweme and the staff at Orlando Orthopaedic Center, Dante’s story is one of overcoming trauma and regaining strength. There is a lot that can go into a patellar fracture, and every patient needs specialized care to make sure they can regain full mobility.
What Is Patellar Fracture Outpatient Surgery?
- What is a patellar fracture?
- What are the different types of patellar fracture?
- What are the symptoms of a patellar fracture?
- How can surgery help with a patella fracture?
Let us take a closer look at the injury Dante experienced and the surgical intervention that brought him back to the mobility he enjoys today.
What is a Patellar Fracture?
A fracture of the patella happens when the small bone at the front of the knee joint is broken. The knee is the body’s largest joint and is vulnerable to a lot of wear and tear as a crucial weight-bearing pivot point. The role of the patella, or kneecap, is central to the functioning of this joint. The patella acts as the shield at the front of the knee joint, and when it fractures due to a traumatic injury, the ability to extend the joint and walk is hampered.
Despite the prominence of the bone and its vulnerability if you fall to your knees or hit it against the dash in a vehicle collision, a patella break is actually relatively uncommon. That is particularly true when compared to other types of joint-related injuries.
What Are the Different Types of Patellar Fracture?
The kneecap can break in several ways. In Dante’s case, it was not a clean, two-piece break, because the patella bone had broken into several pieces. Langdon says, “We were really nervous about where this was all headed.”
Patella breaks can happen at various points along the bone, and sometimes fractures occur simultaneously in several places. Doctors categorize these breaks as:
- Stable patella fracture, where the pieces of bone remain in place, sometimes in contact with each other
- Displaced patella fractures, which happen when the broken pieces of the kneecap are separated and no longer align
- Comminuted fractures, which are when the patella shatters into three or more pieces
- Open fractures, which displace the bones so they emerge through the skin
Dante was diagnosed with a displaced comminuted fracture of the left patella. These fractures are painful and make it very difficult to stay mobile. In Dante’s case, his mobility was severely affected.
Langdon says, “Dante lives alone and his walks are everything. His walks are his fitness, which helps with his mood.” Having surgery with Dr. Adigweme and his team “altered it back to where he can do that again.”
What Are the Symptoms of a Patellar Fracture?
Pain, bruising, and swelling occur on the kneecap with a patellar fracture. However, because the knee joint is complex, these symptoms could also signify injury to other parts of the structure.
The primary symptom of a patellar break is the inability to straighten the knee. This was the case with Dante. Dr. Adigweme says, “Your patella helps you extend your knee, so he (Dante) was unable to extend his knee and had significant difficulty walking.”
To diagnose the condition, an orthopaedic physician typically will undertake a physical examination and medical history. This includes manually palpating the kneecap, where you can often feel the edges of the fracture through the skin, particularly if it is a displaced patellar fracture. The doctor usually checks for hemarthrosis, which is internal bleeding that can collect inside the joint space. If you haven’t had x-rays, these are common to confirm the diagnosis.
Together, Dr. Adigweme, Langdon, and Dante decided that an outpatient orthopaedic procedure to repair the patella fracture would be the best approach to get him back on his feet.
How Can Surgery Help With a Patella Fracture?
Surgery can repair and stabilize the patella to speed healing and get you back to your normal activities.
Dante underwent an outpatient open reduction and internal fixation of the left patella with Dr. Adigweme. The procedure took about an hour.
Dr. Adigweme describes the procedure: “Essentially what we do is put the two pieces of the patella back together, put two screws in, and then cable across the fracture.”
Open reduction and internal fixation surgery can be a non-invasive outpatient procedure. The benefits of outpatient knee surgery include less blood loss, smaller incisions, and faster healing. Dante was in a hip to ankle leg brace for about six weeks as the fracture healed.
Today, Dante is back to the activities he loves with his devoted brother at his side. Langdon says, “We are appreciative for taking care of my brother at a time when we weren’t sure if we were going to get this operation done in time without further damage being done. They did that for us.”