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Author Topic: Has anyone else been treated non operatively?  (Read 1362 times)

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Offline ukstormvixen

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Has anyone else been treated non operatively?
« on: September 13, 2014, 04:21:35 PM »
Hi all,
this is my first post on here. Been trying to do some research on progress, as I'm feeling rather frustrated right now.

I should probably start off by explaining what happened!

On July 6th I tripped on some cobble stones, and was taken to an A&E department by ambulance (I am in the UK by the way) where after a speedy examination and x-ray once I was eventually seen was told that I had a fractured tibial tuberosity, which had likely detatched with the tendon attached. Was given crutches and a tubigrip and sent home and told to go to a fracture clinic the next day.

After an awful lot of struggling to get in and out of the car (took an hour and an OD on recommended amounts of Tramadol just to move without screaming blue murder) I managed to settle down, knowing I'd done something serious but assumed this was correct due to never having broken or fully torn anything.
Anyways, I was taken back in as an emergency a few hours later, as I'd lost the blood supply to my foot...

Upon arrival to the 2nd hospital, I was re-examined and my knee (joint, not cap) was clearly dislocated and confirmed as such by x-ray - long story short, in addition to the fracture (which has since been classified as a Tibial Spinal Fracture) I'd also dislocated the joint and severed most/all the tendons, so any movement was causing the joint to move in and out, with nothing to go against, and my lower leg was in effect, hanging off inside the skin!

Anyways, after being stabilised to try and salvage the blood supply (and the leg, I found out later) it was immobilised by means of an x-fix external fixator frame (think meccano) with four pins - two down the tibia and two in the femur - holding the leg straight. I then underwent another operation to remove the saphenous vein in my right leg, and use it as a graft for a femoral-popliteal bypass in my left.

I was in the X-Fix for a month and then put into a cast brace with 90degrees flexion.

I had a consultants appointment earlier in the week, and he confirmed he stood by his decision not to operate on either the knee or the fracture due to the complications (vascular and nerve damage) - the downside being it will take 1/3 longer to fix overall.

I've got the cast brace on for another two months, and working up to full flexion, and also working up to begin to weight bear as well.

I have a lot of questions about what to expect, and all kinds of stuff... .but I've been able to find so little info on the net, both for the actual injuries sustained, as well as treatment and rehabilitation - so I guess my main question is has anyone else been treated non-operatively, and if so, what are your experiences?

Thanks a lot for reading.

Sara


Offline mjeffrey

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Re: Has anyone else been treated non operatively?
« Reply #1 on: September 13, 2014, 07:21:40 PM »
Hi Sara

Sorry about your accident. I have no personal experience with this but maybe I can help you navigate the site to find what you want.
Try this search in google:

Quote
site:www.kneeguru.co.uk tibial spine fracture

There was someone this year who may have had something similar: caraghk.
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=63516.0
If you click on their name and then "Show Posts" you can see their history of Posts. The titles are links so you can go to the original thread.

If you are interested in the surgical procedures this is an interesting site:
https://www2.aofoundation.org/wps/portal/!ut/p/a1/jU_JDoIwFPyaXukD4xJvPShxSYjBBXsxJZZCgm3zWiT69SJnXOY2k5nJDOU0o1yLe6WEr4wW9ZvzySVKAOJVCpsk2YfA0kUYH5cAsBt3hvMXA5v-l4cPYPArv6Zc1Sbvp56ZzkczRTnKQqLEoMFOLr23bk6AQNu2USBMYRp97Q8GBlUnW0fAGvSiJuAaVBIfQ22lcZ5mgyXU3g7ZcytPLx5X3uM!/dl5/d5/L2dJQSEvUUt3QS80SmlFL1o2XzJPMDBHSVMwS09PVDEwQVNFMUdWRjAwMFE1/?bone=Tibia&segment=Proximal&showPage=diagnosis

Apparently if it is non-displaced then non surgical is preferred.
https://www2.aofoundation.org/wps/portal/surgery?bone=Tibia&segment=Proximal&classification=41-A1.3&showPage=indication

Sorry can't be of more help.
Mark
« Last Edit: September 13, 2014, 08:32:38 PM by mjeffrey »
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion