The purpose of the Initiative is to assist regulators in determining whether and how gas production from the Marcellus Shale and other shale formations in Maryland can be accomplished without unacceptable risks of adverse impacts to public health, safety, the environment, and natural resources.
The Patella fracture may consist of a single crack across the kneecap or the kneecap may be broken into several pieces, in what is known as a 'stellate' fracture. In some instances a forceful contraction of the Quadriceps muscles can be enough to cause a fracture of the patella. This causes a horizontal crack across the knee cap, which makes it impossible for the patient to straighten their knee.
Once a person has fractured their knee cap, many symptoms will occur. Severe pain and swelling will be present along with some deformity in the knee area and thigh. If the knee cap is totally fractured, it may be possible to feel a gap. The patient will be unable to walk with a broken knee cap or put weight on or lift the knee area, although the ankle and toes can normally be moved as usual, except if there is injury to the neuro-vascular system in addition to the knee cap. Knee fractures can be a series of small cracks or a single or multiple break.