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Author Topic: 13 year old girl with Tibial Plateau Fracture, minimally displaced, Newbie mom  (Read 2726 times)

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Offline trueboo

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Hi everyone, I stumbled onto this site and am hoping to gain some knowledge and direction to help my daughter.  She is a small 13 year old, just starting to finally grow a bit (!) and saturday night she ran/fell we're not sure, while playing tag, into the path of a car.  Thankfully the car was going pretty slow, but she is only 75 lbs so  it was still car vs little girl.  At first she was embarrased and probably in shock and hopped around doing a dance to show she was fine.  I didnt witness the hit so I didnt realize the severity.  We had her sit and rest and eat some dinner, because she kept insisting she was completely fine.  The knee started to get huge, and we called our local urgent care, they were closed and the on-call physician stated if she was not in excruciating pain there was no need to go to the ER and to bring her to urgent care in the morning.  We did just that, and they did an xray that showed she had a possible tibial plateau fracture.  MRI confirmed this the next day, and the following day, tuesday, she was seen by a pediatric orthopedic dr and placed in a cast from groin to ankle.  The MRI showed the fracture and though I have not been given the report, I was told that it was a 2mm minimally displaced fracture, and the soft tissues seem mostly ok, though i guess there is some disagreement if the ACL is affected or not. I need to get that report!! Well the pediatric orthopedic dr said she would be in a "walking cast" and should put her weight on it.  Yesterday was the first day of this, and the cast was rubbing her ankle and achilles tendon pretty badly and we had to take her back in and they recast it today.  The dr didnt do the cast, both days it was a young tech.  Yesterday's cast, was comfortable except for the rubbing problem.  Today's cast, the leg seems hyper extended, bowed with the knee towards the back, and while the rubbing problem is resolved, her leg is now killing her.. I called the on- call nurseline that our insurance offers, and she stated to call the dr first, and then suggested ER.  When I called the dr, he said the leg is supposed to be in that position, and that there was no need to go to ER and they probably wouldnt do anything anyway but cut off the cast, if that.  I asked him why the first cast was in a totally different position yesterday, with the leg in a comfortable slight bend, vs today's hyper flex position, and he didnt really respond.. So tomorrow morning (thursday) I am supposed to take my girl there first thing in the morning to get the cast redone AGAIN, but since then, i have read all this stuff online, and seen that the majority of cases of TPF were not allowed to bear weight for weeks if not months.  And many are not casted at all.  I am so confused if she is getting the proper course of treatment, am kicking myself for not getting her to ER that first night, and dont even know how to go about a second opinion at this point.  HELP!!  Also I am confused about calling insurance company of the driver that hit her, when i'm not sure if my daughter darted out or what.. Any advice or opinions would be helpful. Thanks for listening!

Offline TwoBadKneesUSA

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If there was a car involved in hitting someone, the police should have been called and a report done.  Check with the police in that jurisdiction.  If you have the insurance information from the driver, call the company and just explain you want a second opinion.  If they don't cover that, then your regular health insurance should (if you have any that is).  If you have health insurance, call them for a list of pediatric orthos in your area and make her an appolntment.  Protocols may differ with adults and children, I would think it may have something to do with growth plates.  Hope your daughter comes through this ok.  It is so tough when your kid is hurting....good luck.
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline maryc

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Since your daughter has a minimally displaced fracture casting is the usual protocol.  The idea is to stabilize and protect the knee during the healing process.  For the majority of us that means surgery to install plates and screws. 
Weight bearing can be used to promote quicker healing.  It's possible that for someone as young as your daughter this is the correct procedure.
If you have any doubts get a second opinion.  As mentioned your insurance company can provide you with a list of pediatric orthopedic mds.
Sending healing rays your way
8/4/07 fell
8/5 diagnosed TPF
8/6 surgery plate and 6 screws
8/12 out of hospital NWM
8/21 staples removed
9/18 OS appt - WBAT with crutches
10/10 - WBAT with cane
10/27 - back to work w/cane
12/26 - no cane, slight limp when tired
1/25/08 - released from PT, no limp
2/3/09 - Released by OS

Offline missmyknee

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You can also try posting down in the Bone Breaks Around the Kneesection. Here is the link:

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=21.0

Also go to 

www.mybrokenleg.com

This is an excellent website as well

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline trueboo

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Thank you so much for the replies! We do have insurance, and we do know the driver of the car, he was a classmate of my older daughter's and lives in our neighborhood.  I guess we need to give him a call.. The leg feels a bit better this morning and I am getting some work done here while I decide how to proceed.  It's just hitting us how serious this is, we felt a false sense of things being ok from her initial reaction,  and reading all the things everyone on this site has had to go through, I feel so bad for my daughter and all the others who've had to deal with these knee problems.  I wish you all well with your own recoveries, and I will definitely continue to read up about things on here, and send a few friends to this site as well. I'll let you guys know what we find out.  -Sue















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