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Author Topic: badly broken patella  (Read 4187 times)

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Offline smoser

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badly broken patella
« on: October 04, 2010, 01:49:02 AM »
I am new to this site and new to broken bones. I'm 25 years old and I slipped at work and broke my patella (knee cap) into several pieces.  I had surgery on the Aug 26th and it has been almost 5 weeks since the operation.  The doc pieced everything together with stainless steel wire.  I was in the hospital for four days on morphine and they slowly weaned me to pain killers.  When they got into surgery my break was worse than expected and I have been in a knee imobilizer since.  I am still non weight bearing and really frustrated. I'm still having some pain, my foot and ankle swell if I get up and move around with my walker.  The outside and top part of my kneecap are still numb.  I have my 5 week check-up  tomorrow and I'm really afraid they are going to tell me I'm non weight bearing for another 3 weeks.  Any suggestions on how long this is going to take.

Offline arthriticknee

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Re: badly broken patella
« Reply #1 on: October 04, 2010, 05:12:19 AM »
Hi Smoser,
Sorry to hear about your knee.
It is not uncommon for them to get in there and find out that the fracture was worse than the x-ray suggested.
I am assuming you had what is called a Tension Band Wiring. This type of fixation is used on bones where large muscles attach. The wire compresses the fragments back together and resists the pull of the quadriceps muscle.
If the fracture was difficult to reduce and there was even the slightest concern over the fixation they will take it pretty carefully in the easly days until the break starts to heal.
Bending your knee has the effect of pulling the fragments apart, hence the knee immobilizer. 5 weeks is a reasonable amount of time so there is a good chance they will let you do a bit more after your review. Obviously your doctors will assess you and will recommend the best treatment for the long term. If that means more short term limitation you will just have to be patient.
Just make sure you follow all instruction regarding weight bearing, the introduction of knee flexion and quads exercises. If you aren't ready for them yet you will be soon. You don't want to jump the gun and do something your knee isn't ready for.
Sounds like you did a good job injuring yourself, now its time to do a good job recovering. ;D
All that you described is unfortunate but not that unusual in the world of patella fractures.
Good luck.
Remember that any advice on an online forum is of a general nature.
You are always advised to be assessed by a medical professional so your individual situation is addressed.

Offline 95stang5.0

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Re: badly broken patella
« Reply #2 on: October 05, 2010, 10:38:54 PM »
Hey, I to broke my patella. I broke it on June 6th 2010 and had surgery on the 8th. I have three pins and wire. Its a long slow process of recovery I was non weight bearing for at least 6 weeks. then crutches with leg kept straigt weight bearing I think it was about 12 weeks before i was told to walk with nothing but my legs. Its hard to do. Leg muscles are gone so take your time do your pt, when your sitting around bend bend bend when you get the ok. i am about 105 degrees now and back at work light duty. It doesnt feel to bad, at the end of the day its sore but not bad. i cant walk up and down stairs yet normal. Have to do one step at a time. Obvioulsy cant kneel on it dont know if i ever will be able to. But keep your head up and have paitance. What do you do for a job? Do u have to have a 2nd surgery. Mine is going to be in april hopefully. I cant wait already to get hardware out. Good luck.

Offline aussiegirl1

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Re: badly broken patella
« Reply #3 on: October 06, 2010, 02:09:14 AM »
Hi Smoser,   
Sorry to hear about your fall.  I too have had a broken patella.   I had it wired around the patella, figure 8 over the top and two clips.  I broke mine in March 09 and can tell you that it is a very long slow recovery process.   I was in a brace for 8 weeks after the first surgery.  I could weight bare however the thought was very frightening.  I was not to bend my leg at all for those 8 weeks.  After that time I started physio which again was very overwhelming for me.  I couldn't understand how your leg could bend with all the wire in it.  My wire was to stay in for 12 months however by around 9 to 10 months my knee looked as though it wanted that wire out so I made it to 11 months and had the wire removed Feb 2010. 
I was excited to get the wire out as I was really hoping to progress with the degree of bend.  I am at a grid lock now - 18 months later - at 100 degrees.  I work on my leg at the gym a couple of times a week.  I am active with young children and am very suprised that I have not got anymore ROM.  I still have numb areas and sensitive spots around the knee.  I would say it has only been the last couple of months that my knee is starting to look like my other knee (but with a scar down the front). 
Be patient and work at it as soon as you have the all clear.  You need to take the relevant time in this early stage to ensure the bone heals as best as it can.  Although I don't have the range of bend I would like I can say that I have not been in any discomfort.  It was instant relief when that wire was removed.    Best of Luck 

Offline ryanlum

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Re: badly broken patella
« Reply #4 on: October 08, 2010, 08:44:45 AM »
hey guys, wanted to ask you all, after you have broken your patella, is the knee cap rough and is the knee cap poking into the knee gel?

Offline surrender

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Re: badly broken patella
« Reply #5 on: October 08, 2010, 02:08:13 PM »
So sorry to hear about your injury.  I broke my patella almost 7 weeks ago.  I am thankful for the progress I have made.  What I wanted to address to you is the emotional part of this kind of injury.  I am a very strong person and I was not prepared for the despair that is associated with an injury that changes your life so dramatically.  I wish I could say I did it gracefully.  Some days I was anything but.  This forum is so helpful because the people around us don't know what it's like and it wears on them too.  We can blab about it all day long on here and feel some relief.  Each injury is different and each person is different.  We have to balance wanting to get well and not overdoing and on the flip side not doing enough so we don't progress.  I was very frustrated because I could not get my knee to bend past a certain point for weeks no matter how I tried and did all the physical therapy and exercises at home.  It takes time for bone to heal and that's the goal.  Our injuries are certainly a challenge in our lives and we will never be the same after this journey.  Be encouraged and whatever little progress you make is a victory at the end of the day.   

Offline guy84

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Re: badly broken patella
« Reply #6 on: October 10, 2010, 10:07:35 PM »
Hi,
I broke my knee cap on 21st April 2010, I was 25 at the time, had a similar injury with the top 3rd of my patella severly broken.
Had it wired back together the following day with the 2 vertical wires and a figure of 8 to prevent movement.
Full leg cast for 6 months, non weight bearing. Basically bed ridden.
Had physio and saw instant improvements, reaching 50degree bend in a couple of weeks.
However since then I have struggled, im stuck at 70degrees of bend 6 months post surgery.
The doctors initially warned me it may be a problem due to the wires interference in the knee joint.
The Xrays show the wires are aprox twice the length of my knee cap and so are very prominant when I try to bend it.
My 3 months check up resulted in them telling me the wires were to blame but that due to the extent of the damage to my knee I was not elligable to have the wires out for atleast 6 months.
On my 6 month check up they decided the wires were not effecting the movement and that they were not confident in removing the wires after all. Thinking the problem was more likely due to the extent of the damage to the joint.
Im no docter but im scheptical, I do not see how the wires could not effect the movement and though my patella was severly damaged it did take the brunt of the impact and dont feel any other concerns with my knee.
The one thing I will warn is every knee break is different. Despite my problems I am optimistic. It barely hurts and I do feel the doctors are only doing what they feel is best. I can walk, drive and work. I do the step machine and cross trainer to stay fit.
I wish you have a speedy recovery.

Offline bikemessengerboy

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Re: badly broken patella
« Reply #7 on: October 12, 2010, 05:45:21 PM »
i broke my kneecap 7/29/2010 had surgery 8/5/2010. had wires inserted in the kneecap much the same as has been desribed to you in other replies. its a long process and it actually depends on the person and the degree of activity you are used to. i ride a bike every single day and i'm extremeley active (i'm 42), its been 8.5 weeks since my surgery and i'm completely weight bearing, no crutches, no can, and at 112 degrees range of motion. i'm making about 2-4 degrees of motion a week, but i also work out at home every single day and bust my butt at PT. learn to love the exercises and the PT. it will speed things along.
you have to listen to your body and not push to hard when you can't and realize that this is a long process. very long. even though i've made astounding progress in less that 9 weeks i have no illusions. i won't be riding my bike on the street till spring. take your time, don't be discouraged and keep your mind strong.

good luck

Offline poppy

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Re: badly broken patella
« Reply #8 on: November 06, 2010, 11:41:58 PM »
Hi I broke my patella at the beginning of Sept 2010.  I have found it a really frustrating experience. I had an operation and wires placed into my knee and was not allowed to bend my knee for 6 weeks. I am now 10 weeks on and can bend just past 100 degrees. However, I am still on crutches and struggling with straight leg lifts. Sometimes i feel like i want to cry but reading stories on this board has really helped

I wish you well in your recovery. As hard as it can be just follow what your PT says.

Offline coral 251

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Re: badly broken patella
« Reply #9 on: November 08, 2010, 09:28:04 AM »
Hi smoser,
I too broke my patella into 3 pieces,and had the usual repair procedure with the 2 pins and figure of 8 wiring,this was in march, i will be 8 months post-op on the 26th november.
The cast was on for 7 weeks,and i was non weight bearing during this time.
When the cast was removed, i had a further two weeks non weight bearing,and just allowed to do slight bending exercises whilst sitting.
Its not been easy,but now, at approaching the 8 months mark, i think i am finally getting somewhere,i have got full ROM,just slight tightness and stiffness,and the only pain is when stair climbing,one or two issues remain which are hardware related, but i have to wait at least 12 months to have this removed.

All injuries are different, as is the way our bodies heal etc,and all drs seem to have their own methods of treatment and advice for this injury,so just follow all the advice given to you by the OS and pt,and dont forget to ask questions and make sure you get the answers you require.
Its a long hard journey to recovery,you will have your good and bad days,and may-be one or two setbacks and disappointments along the way,but keep positive,and try not get too down in the dumps,and keep clicking on to this site, which will keep you going,its been a lifeline to me ,and every-one on here says the same.
So i wish you well in your recovery,and hope all goes well.
 All the best.
coral

23/03/10 displaced patella fracture 3 pieces right leg
26/3/10 had op,2 pins & figure of 8 wiring
full cast ankle to thigh 7 weeks.
18/5/10 cast removed xray showing hairline crack
26/7/10 walking unaided,full rom
31/10/2010.6 months post-op check,bone not healed,harware cant be removed

Offline surrender

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Re: badly broken patella
« Reply #10 on: November 10, 2010, 01:20:29 PM »
I'm so thankful for Knee Geeks!  I have posted many times on different threads and got on today to check up.  I had my last pt appointment on Monday, and needed some encouragement.  I too broke my patella and have the figure 8 wire.  After 3 months my ROM is at 110 and my therapist wanted me to reach 120 by then.  Her last words were that I probably would not advance and stay in this place.  That was quite a blow.  I work my knee and it seems to take 2 weeks to finally move 5 more increments.  Now, it feels like it's locked.  It might not be but that's what it feels like.  I'm not sure if forcing my knee is a good idea since I cannot see what's going on in there.  My doctor does not want to remove the wire until Summer.  How do you know if it's scar tissue, the wire, or what's holding it up?  How do you know if it's time to push or not?  Thanks guys!

Offline coral 251

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Re: badly broken patella
« Reply #11 on: November 10, 2010, 01:53:47 PM »
Hi Surrender,i think 120 rom is quite good at only 3 months post op,i was told i had reached full rom very quickly by my PT,and that was at 4 1/2 months,it is hard work, and you do have to suffer pain to get there,and scar tissue can play a big part in restricting ROM.
Keep at it,do as you are told to do,by your PT and OS,and you will get there.
Once you have reached full rom,unfortunately, the problems and pain dont end,i am now approaching the 8 months post-op stage,and only just starting to see the light at the end of the tunnel.
Do try to remember,every bit of progress is an achievment,no matter how slow it may seem to get there.
This week for the 1st time,i can see a vast improvement,most of the problems seem to have gone,and i am feeling so elated.
The hardware is still in place,and the os wont review this until my appointment in february,that being 11 months post-op.
Its been a long uphill struggle,but hopefully i am over the worst hurdles, and i am now thankful as to how far that i have come, so stick at it, keep positive,and of course,keep clicking on the KG site for encouragrment and advice,like you and every-one else says. its a godsend,may it long continue.
 Wishing you well.
regards
coral
« Last Edit: November 10, 2010, 02:25:56 PM by coral 251 »
23/03/10 displaced patella fracture 3 pieces right leg
26/3/10 had op,2 pins & figure of 8 wiring
full cast ankle to thigh 7 weeks.
18/5/10 cast removed xray showing hairline crack
26/7/10 walking unaided,full rom
31/10/2010.6 months post-op check,bone not healed,harware cant be removed

Offline surrender

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Re: badly broken patella
« Reply #12 on: November 10, 2010, 03:16:01 PM »
Thanks Coral.  I'm actually only at 110.  I believe it will come in time and with work.  Ever since I took off the brace, which I really don't like to wear at all anymore, it's been a struggle.  I seem to have both knees in pain.  By evening, I really hurt.  I do not take pain meds and haven't taken anything for a long while.  It's really hard on the stomach and not for long term use, even just over the counter meds.  I seem to have been sitting in this place for at least two weeks.  Again, I was not expecting this from going from the brace to no brace.  I know there is compensation going on but have not read others talking about it.  I was able to do a few full rotations on the stationary bike on my last pt visit but my eyes stung with tears!  Dang!  That hurt!  I was thinking of trying to purchase a used stationary bike.  If I can do full rotation with little pain, I will know I am increasing ROM.  Any thoughts?  Terri

Offline coral 251

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Re: badly broken patella
« Reply #13 on: November 10, 2010, 03:32:29 PM »
Actually, its funny you should mention the exercise bike,i just purchased a brand new one just over 2 weeks ago,it was only 69.99, off amazon,its a V fit triple action,started off doing 2 minute sessions 10 times a day,then went to 3 mins, then 4, and basically increased the mins, and cut down the no of sessions.
This is what i think has helped me the most,this and the water aerobics.After the 1st couple of days using the bike my leg was stiffer and more painful than ever,but i had a rest day, then persevered,not looked back since, just keeps getting easier,and yes,even the stairs,are easier,i will soon have conquered those.
Good luck with it,but dont push too hard, to the point of pain, then stop,advice given to me by PT.
     coral
23/03/10 displaced patella fracture 3 pieces right leg
26/3/10 had op,2 pins & figure of 8 wiring
full cast ankle to thigh 7 weeks.
18/5/10 cast removed xray showing hairline crack
26/7/10 walking unaided,full rom
31/10/2010.6 months post-op check,bone not healed,harware cant be removed

Offline surrender

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Re: badly broken patella
« Reply #14 on: November 10, 2010, 10:52:33 PM »
Thanks so much Coral.  I appreciate it. :)