Knee Fracture 

  • Author: Mark Steele, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Feb 9, 2011
 

Background

Fractures of the knee include fractures of the patella, femoral condyles, tibial eminence, tibial tuberosity, and tibial plateau.[1, 2] Direct and indirect forces can cause these fractures.

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Epidemiology

Frequency

United States

Patellar and tibial plateau fractures each account for 1% of all skeletal fractures. Distal femoral condyle fractures account for 4% of all femur fractures.

Mortality/Morbidity

Fractures of the knee can result in neurovascular compromise or compartment syndrome, with resultant risk of limb loss.[2] Soft-tissue infection or osteomyelitis can occur with open fractures.

Other complications include nonunion, delayed union, osteoarthritis, avascular necrosis, fat embolism, and thrombophlebitis.

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Contributor Information and Disclosures
Author

Mark Steele, MD  Associate Dean for Truman Medical Center Programs, Professor, Department of Emergency Medicine, University of Missouri-Kansas City

Mark Steele, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey G Norvell, MD  Clinical Assistant Professor of Emergency Medicine, University of Kansas School of Medicine

Jeffrey G Norvell, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Michelle Ervin, MD  Chair, Department of Emergency Medicine, Howard University Hospital

Michelle Ervin, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, National Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Eric L Legome, MD  Chief, Department of Emergency Medicine, Kings County Hospital Center; Associate Professor, Department of Emergency Medicine, New York Medical College

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References

  1. Accousti WK, Willis RB. Tibial eminence fractures. Orthop Clin North Am. Jul 2003;34(3):365-75. [Medline].

  2. Wiss DA, Watson JT, Johnson EE. Fractures of the knee. In: Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott-Raven; 1996:1919-2001.

  3. Bharam S, Vrahas MS, Fu FH. Knee fractures in the athlete. Orthop Clin North Am. Jul 2002;33(3):565-74. [Medline].

  4. Thomas AL, Wilson RH, Thompson TL. Quadriceps avulsion through a bipartite patella. Orthopedics. Jun 2007;30(6):491-2. [Medline].

  5. Walker CW, Moore TE. Imaging of skeletal and soft tissue injuries in and around the knee. Radiol Clin North Am. May 1997;35(3):631-53. [Medline].

  6. Gray SD, Kaplan PA, Dussault RG. Acute knee trauma: how many plain film views are necessary for the initial examination?. Skeletal Radiol. May 1997;26(5):298-302. [Medline].

  7. Davis DS, Post WR. Segond fracture: lateral capsular ligament avulsion. J Orthop Sports Phys Ther. Feb 1997;25(2):103-6. [Medline].

  8. Hall FM, Hochman MG. Medial Segond-type fracture: cortical avulsion off the medial tibial plateau associated with tears of the posterior cruciate ligament and medial meniscus. Skeletal Radiol. Sep 1997;26(9):553-5. [Medline].

  9. Hardy JR, Chimutengwende-Gordon M, Bakar I. Rupture of the quadriceps tendon: an association with a patellar spur. J Bone Joint Surg Br. Oct 2005;87(10):1361-3. [Medline].

  10. Nichol G, Stiell IG, Wells GA. An economic analysis of the Ottawa knee rule. Ann Emerg Med. Oct 1999;34(4 Pt 1):438-47. [Medline].

  11. Stiell IG, Wells GA, Hoag RH. Implementation of the Ottawa Knee Rule for the use of radiography in acute knee injuries. JAMA. Dec 17 1997;278(23):2075-9. [Medline].

  12. Mustonen AO, Koskinen SK, Kiuru MJ. Acute knee trauma: analysis of multidetector computed tomography findings and comparison with conventional radiography. Acta Radiol. Dec 2005;46(8):866-74. [Medline].

  13. Kilgore KP. The knee. In: Emergency Management of Skeletal Injuries. St Louis, Mo: Mosby-Year Book; 1995:439-99.

  14. Newton EJ, Love J. Emergency department management of selected orthopedic injuries. Emerg Med Clin North Am. Aug 2007;25(3):763-93, ix-x. [Medline].

  15. Roberts DM, Stallard TC. Emergency department evaluation and treatment of knee and leg injuries. Emerg Med Clin North Am. Feb 2000;18(1):67-84, v-vi. [Medline].

  16. Konstantakos EK, Dalstrom DJ, Nelles ME, Laughlin RT, Prayson MJ. Diagnosis and management of extremity compartment syndromes: an orthopaedic perspective. Am Surg. Dec 2007;73(12):1199-209. [Medline].

  17. Gaston P, Will EM, Keating JF. Recovery of knee function following fracture of the tibial plateau. J Bone Joint Surg Br. Sep 2005;87(9):1233-6. [Medline].

  18. Koval KJ, Zuckerman JD. Lower extremity fractures and dislocations. In: Handbook of Fractures. 2002:210-234.

  19. Sanders AK, Boggess BR, Koenig SJ. Medicolegal issues in sports medicine. Clin Orthop Relat Res. Apr 2005;38-49. [Medline].

  20. Mustonen AO, Koskinen SK, Kiuru MJ. Acute knee trauma: analysis of multidetector computed tomography findings and comparison with conventional radiography. Acta Radiol. Dec 2005;46(8):866-74. [Medline].

 
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