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The knee is one of the largest, most complex, strongest, and most important joints in the human body, as it allows the leg to bend and straighten, while it also supports the body weight. Everyday movements such as walking, jogging, standing up, and even sitting, are possible thanks to the knee, which stands out from the other joints because it is “designed” to allow, albeit to a lesser degree, the medial and lateral rotation, when it is slightly bent.
The femur (the “background” of the thigh), the patella, that acts as a pulley, the tibia, that supports the thigh, and the fibula, that offers a point of traction to many muscles, work together to form the joint. Knee fracture is a severe and serious injury, which means that one or more bones are broken, shattered, or crushed: the patella, the distal end of the femur (femoral condyles), and the proximal end of the tibia (tibial condyles). Osteochondral knee fractures involving the articular surface and the underlying bone are also common injuries: an osteochondral fragment is detached and moves inside the joint.


Knee fractures are often the result of severe violence, such as a car accident, a work accident, a fall, or a direct hit to the joint. It is also considered a sports injury. High risk groups include individuals of over 60 years, due to osteoporosis (in these cases, even a simple fall to the ground is enough), as well as those with concomitant health problems (cardiological, pulmonary, nephrological, or diabetes).


The most common symptoms are pain due to loading, edema (swelling), and bruising, tenderness on palpation, deformation - the knee may look like it is out of position, and the leg can look shorter and deformed -, and even the sensation that the broken bones “rub” onto each other during movement (crepitus).


Treatment depends on where the injury is found, the number of bones that are involved, and the type of fracture. The most serious ones to treat are intra-articular fractures, when the injury extends to the joint, causing the surface to be divided into several fragments.
Open fractures are treated surgically, within at least three days, and require special operations of reduction and osteosynthesis. However, surgery is nowadays also recommended for older patients with osteoporosis, due to the use of modern surgical techniques and sophisticated materials.
In the patella, any fissured and non-displaced fractures (attention is required, in order to make a proper diagnosis and for them to not to be regarded as common knee injuries) are treated conservatively. However, displaced fractures require surgery, in order for the articular surface to be restored, and for the risk of post-traumatic osteoarthritis to be reduced.
When there are femoral condyle fractures, we are usually talking about a polytraumatized patient. It is a very serious injury that is surgically treated, in order for anatomic reduction, joint reconstruction, and stable osteosynthesis to take place, in order for the risk of post-traumatic stiffness to be reduced.
The vast majority of tibial condyle fractures are treated surgically, nowadays with arthroscopy, the minimally invasive method through which the fracture is anatomically reduced and stable osteosynthesis takes place, with small incisions, instead of the classic large incision of an open surgery.
In the case of osteochondral knee fractures, surgery is required in order for the osteochondral fragment to be removed, if it is small, and/or for large fragments to be fixed with absorbable pins.

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