Knee Fractures in adults are potentially devastating conditions. The immediate swelling and displacement of the fracture fragments often causes damage to the nerves and blood vessels which run at the back of the knee. Excessive swelling may also lead to a condition called compartment syndrome, where the small blood vessels in the leg are blocked off due to excessive pressure. This may then lead to muscle death in the leg and may require emergency surgical decompression.
If a fracture around the knee is suspected, urgent x-rays and fracture immobilisation is required. An orthopaedic opinion is always required and, although surgery is not a given, it is required in the majority of cases in order to realign the mechanical axis of the leg and in order to accurately reduce the displaced fracture fragments which involve the knee joint line. If these measures are not taken, the patient is prone to the complications explained above, as well as at significant risk of developing accelerated onset osteoarthritis.
Fractures of the tibia all the lower leg bone are also prone to the above complications and they require similar emergency management. Non-surgical management is not out of the question here either, but usually intramedullary nailing is an ideal and minimally invasive method of enabling the patient to begin walking again within days or weeks of injury. Fractures which are not suitable for intramedullary nailing may be plated. With the latest locking plate technology and minimally invasive approaches this has proven to be extremely successful with regards to function as well as fracture healing.
