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Author Topic: 9 week OS checkup (for severe patella break) tomorrow-need advice please!!!  (Read 937 times)

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Offline Sara Z

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Hi!  Been reading the site for weeks, and finally having courage to ask for help.  I'm a 40 yr old mom of 4 (teenage triplet daughters) and baby 18 month old son, who took a freak slip and fall in our home August 1st.  Severely broke my patella in half, clean across the mid-section.  Unfortunately, I cannot attach my x ray pics for some reason, but (I am writing  on an iPad-any suggestions?) the profile pic of the original xray looks more like an open crab claw, rather than a patella.  It was open almost an inch between the two pieces, and the retinaculum (sp?) was torn in both directions at least an inch. 
I had emergency surgery the day of the accident, and remained in the hospital for over 4 days for pain control.  My original surgeon put me in the wrong brace, assembled it wrong, and was extremely unsympathetic from day 1 re: pain control.  In our last conversation, he told me that in 25 years, he had never had a patient still in pain after 4 weeks, except for me.  The worst frustration I had with him, that I didn't realize until after reading this site, was that on the way into the OR, he told me that I would be up and around and back to normal in 6 weeks.  That set up everyone's expectations of my recovery (including my own) to fail.  I have thought there was something
wrong with me, or I was being weak willed, etc.  No, I've instead learned an important lesson from all of you, that this is such a rare injury, as well as a difficult one to recover from, that we are having a hard time finding Dr's
and PT's that have ever had experience treating breaks as severe as mine. 

I found a new surgeon who treats two of our national sporting league teams here in town.  l feel much more comfortable with him and his team, however, I do plan to ask tomorrow if he has ever treated this type of break before.  The last visit he seemed very disappointed in my lack of quad strength.  He put me in a Flexion Extension brace that is still locked at 0 degrees.

So here are my questions:
After 9 weeks, is it still normal not to be able to do a Straight Leg Raise?  I am doing E-Stim 2-3 times a day with my home PT routine. 
Because of concern for not getting enough outpatient PT visits approved by insurance, I have been continuing to have in-home visits by a traveling PT.   Are there markers I should be hitting before switching to Outpatient PT?  Or should I just get there ASAP to speed recovery? 
My quad has not been firing, and now does in the slightest way, despite how hard I try.  Is this normal, or is it
necessary to do muscle/nerve tests that involve placing needles into the muscles-whi h sounds awful?
Does it seem ridiculous that I still have to depend on a walker? My ROM using my hand to help push the knee up is about 80-90 degrees.
Also, swelling is starting to decrease, which is good, but the wires are starting to become visible and painful, especially while trying to sleep, which is bad.  Any suggestions to make (especially side) sleeping more comfortable with the wires? Will the rods/pins become visible too?
Lastly and most importantly, are there any questions anyone could advise me to be asking of my new surgeon?  That is my main concern, as the more I read on this site, the more i learn and worry those treating me are not up on the latest and greatest information.

Sorry for the length of this post.....I had trouble knowing what to leave out!  Thank you very much!!!
« Last Edit: October 07, 2011, 06:07:14 AM by Sara Z »

Offline kneepaincure

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A patella fracture is a serious injury and it's terrible that the first doctor didn't fix it correctly. You are right about asking your surgeon whether he has treated this kind of injury before. Just being in charge of a sports team is no guarantee of a good doctor. Let us know what the new doctor says!
Have had tilted kneecaps for many years, and occasional patellar tendinitis.

Offline elliottl73

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It sounds like you have had a horrible time of it.  I haven't suffered your injury however have had experience with awful doctors.  My daughter at 15 had a swimming injury to her shoulder.  sugery was reccomended we thought we had a good doctor.  She has an awful time with surgery. She did PT after and thought she was doing well at first.  So we let him operate on my husbands shoulder too. BIG mistake.  My daughters surgery failed and we were referred to our current OS.  He has treated many swimmers at UNC at first he reccomended trying more aggressive PT. But in the end another surgery a year later(poor kid).  Well in the mean time my husbands didn't turn out  so well either and they told him to learn to live with it nothing could be done.  He had ruptured his bicepts tendon so that is 2 failed sugeries from same doctor.
  I guess the moral is research your surgeon and if you don't like them try another.  We are very happy with our current OS. He has operted on my entire family now with my knee and we are preparing for yet another sugery in NOV on my knee.

Good Luck,
Laurie :)
9/2010 fell broke nose and injured L knee
10/2010 MRI  negetive
1/21/2011 diagnostic arhtroscopy woke up with MFX
8/11/2011 new MRI showed failed MFX
9/1/2011 Biopsy for carticel
11/1/2011 ACI
5/31/12 scope and microfracture again 1/2 ACI failed
9/2/12 Scheduled OATS,Osteotomy

Offline gbaze54

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Sorry to hear of your troubles. I know how hard it is to try hard and then fail.  It's NOT your fault.  There is no reason for a doctor to blame you for not trying hard enough.  I've heard that same thing.  At the end of June, I slipped and fell coming out of an elevator on some water.  Luckily, I was at the hospital when this happened so I was in the ER within 10 minutes.  I shattered my patella and torn the patella tendon from the kneecap.  What was left of my patella was flipped 180 degrees.  I was operated on and my surgeon decided to repair the tendon and sew it back to the patella.  He did not place the bones back together and left some bone fragments in the tendon.  I was placed in a flexion brace at 0 degrees for 8 weeks.  I slowly began P/T and it was hard at first.  Then it got easier and I managed to get my knee to flex 115 degrees.  I was so happy, my quads were working well and I was working hard at P/T to get my strength back.  I returned to work after 14 weeks, I sit at my desk all day. The following week as I was crossing the street, when my knee buckled on me and I almost fell to the ground.  Since then, I have am still having knee buckling and have lost all my quad muscles.  I am in constant pain and now my OS says I need another surgery to put the bones back together & remove the fragments in the tendon.  If he hadn't screwed up my first surgery I would have been healed in 3 months and back on the go.  BTW, I am 60 years old and was very active.  I am devastated now.  But remember it was my surgeon who erred.  Work hard at P/T and you will get better.  A way I've found to increase the flexability of bending the knee is to sit in a chair w/o your brace and let gravity do it's work. Your knee will slowly bend to the point where it's 90 degrees.  I went to Physical Therapy, had a great therapist and it all worked out good.  Now I have to do it all over again.  Keep the faith, you will get better.  Good luck to you.