Broken kneecaps

[NinjaChick]

[blunt morbid question]What, exactly, sort of injuries/recovery time/level of pain/etc could be expected from someone intentionally having their knees smashed?[/BMQ]

That is, not that the person wanted their knees busted up, but someone else who was bigger and outnumbered him did. Stereotypical mob-style "this is your final warning" type deal. The ideal scenario* would be swinging with a blunt object - pipe, baseball bat, whatever. I'm assuming that, if the impact was hard enough, the kneecap itself would fracture - how is that repaired? Would there be extensive damage to the muscles/tendons/ligaments? What about to the other leg bones - would it effect them?

(paging any doctor dopers, maybe?)

*This question comes from my attempting to make a plot point in a horror/fantasy-ish story I'm writing work, so it's ideal for my plot. I realized upon preview that, really, there's no 'ideal' way to have your knees broken.

[Omphaloskeptic]

IANAD, so this is not authoritative, but: The kneecap is attached by tendons to the tibia at the bottom and to the quadriceps at the top. If the fracture separates these two attachment points (running side to side across the knee) the pieces can pull apart (as the quadriceps contracts), as some of these X-rays (http://www.qub.ac.uk/cm/os/ortho/F/fracture/patella/patella.html) (especially this one (http://www.qub.ac.uk/cm/os/ortho/F/fracture/patella/f5n_14.gif)) show. This is often pretty obvious externally; there's a depression where the patella used to be. Some of the other X-rays on that page show how the reconstruction works: pins (vertically through the patella, with a wire tied around the ends, like this (http://www.qub.ac.uk/cm/os/ortho/F/fracture/patella/f5n_19.gif)) or screws hold the pieces together while they heal. (Do-it-yourself directions here (http://hon.nucleusinc.com/enlargeexhibit.php?ID=583).) Recovery of the fracture probably takes 2-3 months of immobilization depending on how clean it was; after that physical therapy is probably required to regain movement and muscle mass. In other cases the small fragments may be removed and the tendons reattached to the largest piece.

It doesn't seem to me that just hitting the kneecap with a hammer is likely to directly damage any tendons or ligaments (though I could see them being badly pulled in any resulting fall).

[NinjaChick]

Much thanks, Omphaloskeptic

*adds 'broken kneecap' to list of "injuries I really hope to never learn about first-hand*

[silenus]

Well, my elderly mother fell at the neighbors and slpit her right kneecap horizontally. It took her a month to recover. She was in a cast for a couple of weeks, a walker for a week, and therapy for several after that. Total recovery within 3 months.

I hope I inherited her recuperative powers! :)

[sleeepy2]

Two years ago I broke my left kneecap vertically (and my left elbow-what a drag). The pain was pretty bad, but I drove myself to, and home from the hospital. I was out of work for seven weeks.

The real pain was in physical therapy- I had lost significant range of motion and stretching everything back was excruciating. If you've never been to PT, it's like a gym, but everyone trying not to cry from the pain (shudder).

[treis]

Ah yes rehab does suck.

Although the psuedo massages and ultrasound felt really nice on my elbow.

[CynicalGabe]

The fastest way to repair a broken kneecap is to pay Bill the money you owe him on time, like he asked you. Its not that hard, is it? That way it don't get broken in the frist place, see?

[UncleBill]

"Kneecapping" was a serious punishment in Ireland, for those who were traitors to the Cause, I think. One bullet, fired from behind the knee. At the time, it meant a lifetime limp.

[AskNott]

My high school zoology teacher got his kneecap crushed when he was a young man. It never healed, and his kneecap was like a bag of gravel. He said he had been reef-diving, and a wave threw him onto a rock.

[Snickers]

Me mum was in a car accident at 19 (this was way back in the 60s) and busted up her leg pretty badly. However, she never noticed that her kneecap was also involved (she had a whole leg cast on for like 6 months). I was playing with her knee one day and got weirded out because it was all bumpy and knobbly and icky. It was only then that she'd realized she broke it.

I don't know about PT (she's never mentioned it), but she walks just fine and has full range of motion, AFAICT. Apparently the immobilization of her leg allowed all the patella's fragments to knit back together into a kneecap, although not smoothly.

[Misery Loves Co.]

"Kneecapping" was a serious punishment in Ireland, for those who were traitors to the Cause, I think. One bullet, fired from behind the knee. At the time, it meant a lifetime limp.

Yah - Lifetime limp because the bullet shreds the Crucial ligaments that hold the bones together on the inside of the knee. IANAD but I have trouble believing that kind of trauma can be repaired, even by surgery.