Broken Kneecap (Child)

Your child has a break (fracture) in the kneecap (patella). A broken kneecap often causes pain, swelling, and bruising. To confirm a break, X-rays or other imaging tests may be done. A splint or cast may then be put on the leg to hold the bone in place while it heals. If the injury is severe, your child may need surgery. 

Home care

  • If your child has been given crutches, they should use them to walk. Your child shouldn't walk or put weight on the injured leg until the healthcare provider says it’s OK.

  • Give your child pain medicine as directed by the provider. Don't give your child aspirin unless told to by the provider.

  • Keep the child's foot raised (elevated) to reduce pain and swelling. This is very important during the first 48 hours after injury. As often as possible, have the child sit or lie down and place pillows under the child’s leg until the foot is raised above the level of the heart. For babies and toddlers, lay the child down and place pillows under the leg until the injury is raised above the level of the heart. Be sure the pillows don't move near the face of the baby or toddler. Never leave the child unsupervised.

  • Apply a cold pack to the injury to help control swelling. You can make an ice pack by putting ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel. As the ice melts, be careful that the cast or splint doesn’t get wet. Don't place the ice pack directly on the skin because this can cause damage. 

  • Ice the injured area for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed. It may help to make a game of using the ice. But don't force your child to use the ice. 

  • Care for a splint or cast as you’ve been instructed. Don’t put any powders or lotions inside the splint or cast. Keep your child from sticking objects into the splint or cast.

  • Keep the splint or cast dry. The splint or cast should be protected with a large plastic bag closed at the top with tape or rubber bands and kept out of the water.

  • Encourage your child to wiggle or exercise the toes on the foot of the injured leg often.

Follow-up care

Follow up with your child's healthcare provider as advised. Follow-up X-rays may be needed to see how the bone is healing. If your child was given a splint, it may be changed to a cast at the follow-up visit. If you were referred to a specialist, make that appointment promptly.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for the child's protection. Please try to be patient and don't take offense.

When to get medical care

Call your child's healthcare provider right away if any of these occur:

  • Wet or soft splint or cast

  • Splint or cast is too tight. Loosen a splint before calling for help.

  • Increasing swelling or pain after the cast or splint is put on. Babies not yet old enough to talk may show pain with crying that can't be soothed.

  • Toes of the foot on the injured leg are cold, blue, numb, burning, or tingly

  • Child can’t move the toes of the foot on the injured leg

  • Redness, warmth, swelling, or drainage from the wound, or foul odor from a cast or splint

  • In babies, fussiness or crying that can't be soothed

  • Fever (see "Fever and children" below)

  • Chills

Call 911

Call 911 if your child has:

  • Trouble breathing

  • Confusion

  • Trouble waking up or is very drowsy

  • Fainting or loss of consciousness

  • Fast heart rate

  • Seizure

  • Stiff neck

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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