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Author Topic: Please help! Fractured Patella  (Read 1450 times)

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Offline skarie1

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Please help! Fractured Patella
« on: June 02, 2005, 08:37:51 PM »
Hello - I fractured my patella 5 weeks ago. The fracture went all the way through to the joint. I went to my orthpedis surgeon today and he said the healing went well and I need to start rehab next week. Next weeek??? I want the brace off now! I have a 1 and 3 year old and this has beeen torture. What can I expect from PT? Anything I can do to speed it along until then? I can hardly move my knee at all without intense pain and the quadricep has been severely weakened. Dang I had skinny legs before, why couldn't the brace have been on my tummy where I would not have minded dropping a few inches ( ha ha ). Also how long until I can expect to drive again. I feel like this house is a jail!!!! I know I should be happy that all seems to be going well and I realize there are way worse injuries but tight now things are not looking so great! Any advise welcome!!!
Karie

shadehawk

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Re: Please help! Fractured Patella
« Reply #1 on: June 02, 2005, 08:52:45 PM »
Karie,

Hi & welcome to the site.  If you check out the 'Rehab Dept.' - 'Post-op Diary' or 'Specialist Office' - 'Bone breaks around the Knee' you should be able to find the information you are seeking.

Sorry that you are going through this, but it does take time with an injury like yours.  Hopefully, you will have some luck with the rehab. 


Good luck,

Shade

Offline ferris_1972

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Re: Please help! Fractured Patella
« Reply #2 on: June 02, 2005, 10:27:47 PM »
I ruptured my patellar tendon the last week of April and I am just starting PT. I am not sure about the timeframe for your specific injury , however just remember that if you don't rehab the right way especially with your knee then you will have problems later on. As hard as it is and trust me I know. I have an 8 month old and I am going crazy not being able to drive either. I would much rather be bored for the next 2 months during rehab and still be able to chase him around when he gets to be 5 or 6 then to be back on my feet right now and not be able to do that. Just keep in mind that rehab is meant to be a SLOW purposeful process so that you have a great outcome.

Shawn
Rupture Patellar Tendon 4/23/05
Repaired 4/29/05
PT Begins 6/1/05
Return to work 9/1/05

Offline skarie1

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Re: Please help! Fractured Patella
« Reply #3 on: June 02, 2005, 10:45:54 PM »
Thanks for the help! I do not know my way around the site yet. Thanks also for the advice - I know patience should be a must it is just so hard. I am also not a patient person with myself. You are right though and hen you think about the long term affects - I NEED to have patience. What did you do in the PT as I have not yet gone?

Offline tony38

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Re: Please help! Fractured Patella
« Reply #4 on: June 03, 2005, 02:20:13 AM »
Karie,

I'm glad to hear that you've been cleared for PT. A patella fracture is not a common fracture. Aside from the fact that the fractured bone is itself at the joint makes things more complicated.
Did you have surgery? Was your knee immobilized or do you have a brace that allows the knee to bend?
The patella becomes a fulcrum/pulley when the knee is bent/extended and as such is subjected to a lot of pull or tension force.
That's why most OS's immobilize the knee, to allow the bone fragments the chance to touch each other and give it time to fuse together again.
Immobilizing however would result in weaker muscles and scar tissue formation which in turn makes the knee stiff.
Rehab would start off by teaching you proper gait, heel strikes trying to break the limp habit when walking.
Followed by trying to regain ROM, and at the same time manage any pain, swelling or knee warmth.
Followed by muscle/strength training.
An aggressive rehab protocol or therapist early on risks refracturing the patella.
So it is a long road ahead. My OS says he does 40% to get the bone to heal then it's 60% therapy.
It takes a lot of time, patience, good nutrition, good care and don't forget to pat yourself on the back each time you achieve each minor victory.
I remember I was so glad when I was finally able to put on my socks and shoes by myself, be able to drive, walk with very little limp.

Good luck on your rehab, it's going to be tough but hang in there.     
Jan 23/05 fractured left patella, ruptured quad tendon and both collateral ligaments.
Jan 24/05 ORIF 2 wires with 4 pins.
Jan 24-May 5 leg cast/immobilized, no PT.
May 6 finally released for PT, ROM 0-32.
Jun/05 ROM 0-77.

Offline skarie1

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Re: Please help! Fractured Patella
« Reply #5 on: June 03, 2005, 02:17:09 PM »
Tony -
Thanks for all the information. I believe the worst part ( okay besides the no driving part ) Is not knowing what will happen yet. I have a great OS ( One of the best in Tampa - in fact the Team Physician for our pro Hockey team ) but he is not super chatty. How long did it take before you could drive? I did not need surgery ( Yeah!!! ) I had to have the knee drained ( OUCH!! )and then Immobolized extended for 5 weeks. I do not start PT until next week. UGH!!! I took the brace off to sleep last night ( felt great) and have been trying to bend it while in the brace ( unlocking it ). It is really sore and does not bend well. Then I will get it bent and it will feel okay then suddenly pain starts shooting through it. The knee is very hot to the touch and extremely swollen.

Offline tony38

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Re: Please help! Fractured Patella
« Reply #6 on: June 03, 2005, 06:44:58 PM »
Karie,

Was it your right or left leg? I had my left knee injured. So even with a full leg cast I was able to fit and drive an auto shift by moving the driver seat all the way back. This was one week after surgery. No narcotics like Vicodin, just straight Ibuprofen or Aleve. Mind you, I have not been cleared officially to drive by my doc and this is illegal in most if not all states. But it is a matter of absolute need. I have to be extra careful as it will put me in deep doodoo liability wise if I ever get in an accident.
A lot of surgeons don't talk a lot unless you ask them and then they should respond. This is mostly because they have a busy schedule. List your questions on paper next visit so you get the most out of their 'golden time'. Go see your doc as often as you need to if something is not clear or in too much and constant pain. My therapist is very knowledegable and sees me 5 days a week, so she has answered a lot of things for me. But both my doctor or therapist does not make any promises on final outcome or prognosis. As long as there is progress in PT, we keep going and see what we end up with.
At home before I started formal PT, I would repeatedly bend the knee as tolerated. Don't push youself in the pain region without a therapist or doc supervising.
Sitting in a bath tub with warm water helped loosen the knee while bending it repeatedly underwater.
Be sure to ice after and often enough to manage pain and swelling.
Be careful moving getting in and out of the tub and moving about as your weakened muscles make for a wobbly knee and not enough support.     
Jan 23/05 fractured left patella, ruptured quad tendon and both collateral ligaments.
Jan 24/05 ORIF 2 wires with 4 pins.
Jan 24-May 5 leg cast/immobilized, no PT.
May 6 finally released for PT, ROM 0-32.
Jun/05 ROM 0-77.

Offline skarie1

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Re: Please help! Fractured Patella
« Reply #7 on: June 03, 2005, 07:01:16 PM »
Tony,
Right leg - so driving is out as appling any pressure is pure torture. I kepp taking off my brace to try to bend the knee some and am already making small strides. I do not know how you do it as your injury is so much worse then mine. I am having a hard time not being discouraged. When I went to the OS yesterday and he said the bone healed well now put the brace pack on and start PT I wanted to scream. I guess I did not think this through I assumed I would take the brace off and all would be well. Silly me!!!!

Offline giselle

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Re: Please help! Fractured Patella
« Reply #8 on: June 04, 2005, 08:40:22 PM »
Hi, I fractured my patella 8 months ago and had to have 4 hours surgery plus tension band wiring.  I did think I would never walk or drive again but after some amazing acupuncture and good physio in the last 6 weeks am now walking somewhat normally - range 105 from 85.  Had to have an mua after 10 weeks, because bend was only 35 degrees.  You have to be very patient with this sort of injury - dont know how you did yours but I tripped at Brent X in London smashed my knee on a metal post in the upper walkways and ended up in this terrific condition!

It is slow although I am in my 50s and if you are a lot younger you can expect a faster recovery.  Must be pretty difficult with two little children though - I have older ones and a 2 year old grandson.

giselle


Offline tony38

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Re: Please help! Fractured Patella
« Reply #9 on: June 04, 2005, 10:18:06 PM »
Karie,
I had my injury in Jan, and I am in Chicago. With the frigid arctic winters we have here I did not miss being outdoors so much. Snow and ice on the sidewalk is very intimidating with a cast and crutches. A lot different for you I guess in sunny FL. But I know what you mean by being cooped up in the house. I had to basically put my life on hold and focus on my knee and recovery. I had to find a different OS, cancel a couple of summer trips because like you I thought I'd be up and running by now. I may have to change careers, but you roll with punches and take it one day at a time. I had my laptop with me on my bed at all times, and it helped being connected to the outside via the internet, esp this site. PT is not fun at all, I absolutely hate it. But I love the small strides we make in progress and that is what keeps me coming back. My therapist is wonderful and is very good at being a cheerleader. I hope you get a really good one as well.

Giselle - how does accupuncture come in? Is it done at the same rehab facility for you? Is it done to block pain while in therapy? I have a lot of pain while stretching and bending in rehab and looks like the plain old Ibuprofen is not enough. I may benefit from this. Do you know if it helps for swelling as well?     
Jan 23/05 fractured left patella, ruptured quad tendon and both collateral ligaments.
Jan 24/05 ORIF 2 wires with 4 pins.
Jan 24-May 5 leg cast/immobilized, no PT.
May 6 finally released for PT, ROM 0-32.
Jun/05 ROM 0-77.

Offline skarie1

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Re: Please help! Fractured Patella
« Reply #10 on: June 05, 2005, 02:11:25 AM »
Tony - I used to live in Wisconsin and am really gald I did not have to deal with the ice - I slip on that stuff whenevr I go to visit without having to deal with a knee injury. Also I do not have to try to put pnats over that huge brace - no way would mu jeans fit over them. Luckily  I live in the land of short and shorter shorts are in fashion ( then again where do i go that I have to worry about fashion lately??? ). What is your profesion that you might have to give it up? Ther was a PT at my OS office but she was totally unfriendly and forgot to tell me the exercises I was suppose to do the first 5 weeks. UGH! The OS asked if I had been doing my quad exercises and I had no clue what he was talking about. Who know if I had been doing these all along ( okay not the first week - I was on drugs then ) maybe my quad would not look so pathetic.

Giselle - Ouch a metal post??? I have been to london and think I know what you are talking about. Did you have to fly back to the states that way or do you live over there?

Offline tony38

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Re: Please help! Fractured Patella
« Reply #11 on: June 05, 2005, 03:45:09 AM »
I had to ask the nurse for a pair of scrubs bottoms (large size) when I got discharged from the hospital. They were not warm enough but they were the only things I could fit over my full leg cast. In the homepage under menu check out the gym. You will find a lot of good info and pictures on knee rehab exercises. A lot of these are for quads (thigh). Remember to stay in the pain free zone when exercising alone. Right now my injured leg is weak and slender like a woman's (young slender woman that is). I still weigh pretty much the same because the inches I lost in my leg shifted up to my waistline from lack of exercise! Muscle shrink so fast and it is a lot of work to get it firm and defined again. I am an electrical engineer and we build power plants, so a lot of travelling, outdoor construction type work. Aside from that I am in the Naval Reserves where I am about to get kicked out. I may be able to get back in the reserves later if and when when I get medically qualified again. 
Jan 23/05 fractured left patella, ruptured quad tendon and both collateral ligaments.
Jan 24/05 ORIF 2 wires with 4 pins.
Jan 24-May 5 leg cast/immobilized, no PT.
May 6 finally released for PT, ROM 0-32.
Jun/05 ROM 0-77.