Charles Lawrie, MD - Orthopedic Surgeon

Assistant Professor, Orthopaedic Surgery Fellowship Trained in Total Joint Replacement

Dr. Lawrie is an orthopedic surgeon practicing in St. Louis, Missouri. He specializes in Total Hip and Total Knee Replacement surgery

Knee Fracture

What is a Fracture?

A fracture is a condition in which there is a break in the continuity of the bone.

Causes of Knee Fractures

In younger individuals, knee fractures are caused from high energy injuries, as from a motor vehicle accident. In older people, the most common cause is weak and fragile bone.

Types of Fractures

The fractures of the knee can include the following:

  • Distal femur fracture: A distal femur fracture is a break in the thighbone that occurs just above your knee joint.
  • Femoral shaft fracture: A femoral shaft fracture is a break that occurs anywhere along the femoral shaft - the long, straight portion of the femur.
  • Tibial shaft fractures: A tibial shaft fracture is a break that occurs along the length of the tibia or shinbone (larger bone of the lower leg) between the knee and ankle joints.
  • Fractures of the proximal tibia: A proximal tibial fracture is a break in the upper part of the shinbone or tibia. Proximal tibial fractures may or may not involve the knee joint.

Signs and symptoms of Knee Fractures

Fractures that enter the knee joint may cause joint imperfections, irregular joint surfaces, and improper alignment in the legs.  This can lead to joint instability, arthritis and loss of motion. These fractures are caused by stress or trauma, or in a bone already compromised by disease, such as cancer or infection. Proximal tibial fractures can result in injury to the surrounding soft tissues including skin, muscle, nerves, blood vessels and ligaments.

Diagnosis of Knee Fractures

Diagnosis is made through your medical history, a physical examination, and other diagnostic imaging tests such as X-rays are taken to know whether the bone is intact or broken and computerized tomography (CT).

Treatment Options for Knee Fractures

Treatment options include non-surgical and surgical treatments.

Non-surgical treatment involves skeletal traction and use of casts and braces. Skeletal traction involves placement of pin into the bone in order to realign broken bones.

Surgery may involve:
Internal fixation

  • Intramedullary nailing: In this procedure, a specially designed metal rod is placed into the canal of the femur. Then the nail is passed on to reach the fracture site and keep it in place. The rod is secured in place with screws at both ends.
  • Plates and screw fixation: In this procedure, your surgeon will reposition the broken bone ends into normal position and then uses special screws or metal plates on the outer surface of the bone to hold the bone fragments in place.

External fixation

During the procedure, metal pins or screws are inserted into the middle of the femur and tibia and are attached to a device outside the skin to hold the bone fragments in place to allow alignment and healing.

If your bone is fractured into many pieces, a plate or rod is fixed at both ends of the fracture to maintain the overall shape and length of the bone in place while it heals.

In elder patients, where fracture healing delays, a bone graft taken from the patient or tissue bank may be used to form callous. In severe cases, the bone fragments are removed and the bone is replaced with a knee replacement implant.

Complications of Knee Fracture Surgery

The most common complications of surgery include

  • Infection
  • Knee stiffness
  • Delayed bone healing
  • Knee arthritis