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Author Topic: re-fractured patell what to do now?  (Read 976 times)

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Offline sig820

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re-fractured patell what to do now?
« on: October 25, 2008, 05:54:27 PM »
Been reading this site since 8/10/08 and it was a huge support.  But now I need some help.  On 8/10/08 my wife (42yr old, 95lbs) slipped in the garage and fractured her patella with dislocation.  She was admitted through the ER with plan for surgery the next day.  Not having much dealings with broken bones in many years, we picked an orthopedic group who I used for my back sever years ago.

Surgery was planned for 8/11/08 but we had no choice of who from the group would be doing the surgery.  Surgery went very well. Fracture was horizontal in 3 pieces about 1/3 from bottom of patella.  2 pcs were screwed together with vertical screws and the 3rd piece was removed because would not stay in place and it was very small.  We also found out after surgery, that there was severe damage to the knee capsule and that took longer to repair than the patella. 

She was released from hospital on the 14th because they had trouble regulating pain meds due to her size.  We returned to the hospital on the 15th with severe headache, slurred speech, and dizziness.  They were concerned about a blood clot but everything was fine,  pain meds needed to be managed better, so  they had just rushed us out of the hospital because insurance threatened  not to pay a day earlier. 

Follow up visits at the Dr the following weeks went very well.  X-ray showed perfect flat surface of patella and good healing.  Started PT on 10/1, (3 days per week)  by end of week had 30deg ROM.  The next week since original therapist was on vacation had a different therapist much better at explaining things and softer touch.  At the end of second week 40ROM .  We started having concern about arthrofibrosis (as I found articles on this site)  Went to therapist on 10/20 feeling real good,  able to do leg lifts and felt muscle strength starting to return.  Still concerned about ROM but we had ortho appt scheduled for 10/22. 

Therapy on 10/20 as horrible.  Original therapist was very rough with manipulation and it caused severe pain.  My wife said to therapist “this is really hurting today”  therapist said “it’s suppose to”.  Anyhow my wife was in severe pain that evening and next day could not even bend the knee. 

We go to ortho on 10/22 and x-ray reveals patella has re-fractured.  In addition the surface is no longer smooth because one piece  lifted.  Ortho said healing like this will most likely cause pain down the road but never suggestedo operate again right now.  He just said to wait 3 weeks, no bending, no therapy, back to the beginning again. My wife worked so hard to get to where she was and is now once again very upset.

Has anyone dealt with a re-fractured patella?  We  are meeting with the Dr next we to sit and just ask questions that we couldn’t even think of on the 22nd  because of the shock we were in.  We need to find out why we should wait.  How a simple fall could lead to  a life changing event just frustrates me.

I have spent the last 2 days calling all sorts of knee specialists, but most do not want to get involved because she is not 1 year post op.  Can anybody refer  a good knee guy in the NJ area?   

Oh,  And how do you add a list of happenings and dates of bottom of your post?

Thanks,

Steve
8/10/08 Patella Fracture with Dislocation
8/11/08 Surgery
8/20/08 Staples removed
9/8/08 Start PT
9/12/08 30deg ROM
9/19/08 40deg ROM
9/22/08 Patella re-fractured
10/30/08 Specialist says"no fracture"
10/31/08 Back to PT
11/14/08 Stuck @ 40 deg
11/19/08 Arthro Surgery with MUA

Offline fatcats6

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Re: re-fractured patell what to do now?
« Reply #1 on: October 25, 2008, 08:21:44 PM »
Hello Steve,

Firstly, let me say, I feel for your wife, it must be so frustrating and scary to be in the middle of this.  I fractured in patella Feb this year and recovered well, but have dislocated my other knee after a fall.  So a second injury, I can relate just alittle bit.

There's a fabulous person on this site, Ryan Renee and she's a double fracture of a patella.  Her posts would be really helpful to you.  She has such a positive attitude, it's incredible.

Damn and blast that PT!  I can't believe that someone who deals with people in recovery could be so bloody-minded as to push your wife to breaking point, quite literally.  I think the most important thing I've learnt from the knee injury journey is that whilst you rely on medical professionals, you are your own best doctor.  You live in your body and have an immediate connection to the messages it sends out.  If someone tries something on me and it hurts, I stop them and I won't let them continue.  I don't mean little twinges when you're in PT but I do pay attention to the big signals that scream "danger".

Your lovely 95lb wife has one thing on her side with her weight, she's not over burdening her knees with weight, that's great.  Lots of poeple with knee injuries are over weight, or become overweight due to lack of exercise and struggle with it.

I am pretty sure than every single one of us that's suffered a fractured patella is in complete shock at how life changing this injury is.  Even when you've recovered, life is never the same.  Even if you return to your pre-injury physical capabilities, the emotional journey you take changes you forever.  You look at things differently, you see danger where you wouldn't have before and hopefully this protects you.  I find that I tend to watch every step I take when walking. Pity I didn't foresee the step ladder sliding from under me last week-end, that would've saved me so much pain...guess that's why they call it an accident right?

As someone suffering from depression and anxiety, I know how very, very important it is to stay positive.  If your wife is feeling down and upset and shaking her fists at the world (or the PT that hurt her), her healing will be slower.  Seems to be the way we're made.  If she can get to a place of acceptance, all the energy that's expended on being upset can be redirected to healing.  Sounds simple but it's not.  I come here and blubber like a baby, the guys on this site lift me up, dust me off and give me a push in the right direction, and that's forward.
I cry alot, but after I've let it all out, I wash my face and get on with it.  Keep your wife busy with movies or books, a laptop is great if you have one. 

Before I forget, to add things on the bottom of your tag, you need to go into your PROFILE tab, it's up the top of the screen next to the SEARCH button. 

You find alot of surgeons do not want to step on other surgeons toes, they have a brotherhood!  Write down the questions you have for your next visit, it's really easy to get thrown by something they say and you're so shocked by it that all your other questions just fly from your mind. 

Keep posting and honestly, everyone on this site is just so supportive, there's not much that they haven't experienced and so they can help with advice that is a real blessing when you're at your wits end.
Feb 08 Fractured left patella
Jul 08 Released 115 degrees ROM
17/10/08 Dislocated & fractured right patella
2/12 45 deg
6/12 Drove car
16/12 92 deg
21/1 105 deg discharged from PT

Offline sig820

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Re: re-fractured patell what to do now?
« Reply #2 on: October 28, 2008, 02:38:24 AM »
Thanks Fatcat6,

OS called today, after several calls to his assistant who could not give us any answers.  He is hoping the new fracture will go back into place and wants to wait another couple of weeks to see.  He had that patella perfect the first time.  We decided not to wait, and have an appointment thurs. with a knee specialist. 

What stinks about all of this is that she was past the pain and now it has started again.  Not being able to drive even longer means no work and more sitting around the house. 

You are so right about trying to stay positive.  My wife is a social worker and deals with people experiancing the feeling she has gone through over the past 11 weeks.  Talking to her patients on the phone, is a good diversion away from her current issues. 
8/10/08 Patella Fracture with Dislocation
8/11/08 Surgery
8/20/08 Staples removed
9/8/08 Start PT
9/12/08 30deg ROM
9/19/08 40deg ROM
9/22/08 Patella re-fractured
10/30/08 Specialist says"no fracture"
10/31/08 Back to PT
11/14/08 Stuck @ 40 deg
11/19/08 Arthro Surgery with MUA

Offline fatcats6

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Re: re-fractured patell what to do now?
« Reply #3 on: October 28, 2008, 09:45:44 AM »
Really glad to hear you've got a Thursday appointment.  I always feel much better when I know exactly what's going on.  It think you grapple with it and then accept it and no matter how reluctantly, get on with the business of healing.  Let me know what happens won't you.

I found out today that not only had I dislocated my good knee but.....you guessed it....it's fractured, now it's the brace, rest, isolation, no driving, no work, no income once the holiday pay has run out, but it's all good, I don't need surgery and it's not a bad break like last time.  So tell you wife to keep her chin up, now there are 3 of us in the double fracture in a year club and keeping in contact witht he outside world is a good tool to ward off the blues.

Cheers.

Adrienne
Feb 08 Fractured left patella
Jul 08 Released 115 degrees ROM
17/10/08 Dislocated & fractured right patella
2/12 45 deg
6/12 Drove car
16/12 92 deg
21/1 105 deg discharged from PT

Offline sig820

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Re: re-fractured patell what to do now?
« Reply #4 on: October 31, 2008, 12:22:02 AM »
Adrienne,

Sorry to hear about the other knee.  I have learned so much about this stuff since August, it is just so incredible.  I posted today an update about the knee specialist we went to today, its under "ever have 2 very different opinions".  Sherri actually smiled todaywhen we left the Dr.  Be Well.....

Steve
8/10/08 Patella Fracture with Dislocation
8/11/08 Surgery
8/20/08 Staples removed
9/8/08 Start PT
9/12/08 30deg ROM
9/19/08 40deg ROM
9/22/08 Patella re-fractured
10/30/08 Specialist says"no fracture"
10/31/08 Back to PT
11/14/08 Stuck @ 40 deg
11/19/08 Arthro Surgery with MUA















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