[2] Typically the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed.

[2] Also known as a broken kneecap, a patella fracture usually follows a history of trauma and commonly presents with swelling, pain, bruising and inability to both bend and straighten the knee.

The fragment is usually seen in the top outer corner of the patella and can be distinguished from a fracture by being present in both knees.

[1] Treatment may be with or without surgery, depending on the type of fracture and whether the overlying skin is intact or broken.

[2][8] In this case the leg is immobilized in a straight position for the first three weeks and then increasing degrees of bending are allowed as healing occurs.

[2] Most patella fractures are transverse or comminuted, hence the quadriceps mechanism is disrupted and they are treated by a combination of wires in a tension band construct.

[6][8] Open fractures of the patella require emergency treatment with irrigation, debridement and fixation.

[6] Irrespective of surgical or non-surgical resolution to the fracture, a physical therapist can advise on progressive weight-bearing exercises and help with strengthening muscles of the leg, improving range of motion of the knee and in reducing stiffness.

[8] There is limited evidence supporting the different surgical interventions for treating fractures of the patella in adults.

[11] Prior to the 19th century most patella fractures were treated non-surgically with extension splinting, frequently resulting in poorly joined fragments of bone and long-term pain and disability.

[6] The first open reduction and internal fixation for a patella fracture was performed in 1877 by Scottish surgeon Sir Hector Cameron.

Significant advances in surgery occurred in the 1950s with the development of banding after Herbert A. Haxton and others demonstrated that the patella was not just to protect the knee but important for straightening the leg.