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Thread: Broken knee cap- what to do?

  1. #1
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    Broken knee cap- what to do?

    Anyone ever break a knee cap? Well, after 28 years in a chair, I thought I've done it all, but this past weekend I managed to break my knee cap! I was transferring from my ATV to my chair, one leg on the chair, the right one on the ATV foot rest and I slipped- came down in a squat really hard, heard a crack. I checked for anything loose, didn't notice anything, and went hunting. When I got home, I noticed my knee was really swollen.

    Long story short, went to my primary doc who x-rayed it, sent me on to the ER to have an ortho doc look at it. I spent 6 hours last evening at the local ER- was seen by a NP who had more X-rays taken, confirmed it was fractured, but not quite all the way through... They did not call in the ortho doc (huh?). They hardly examined it at all- I asked him to look at the swelling, as I was concerned about DVT's... He ordered an ultrasound, which was thankfully negative. So they wrapped my knee in an ace wrap, charged me $50 and gave me the ortho's name for an appointment. My impression was that they didn't know what to do for a para with a broken knee cap (surprise)...

    Luckily, I have an appointment on Wednesday at Shepherd to see a Physiatrist- I had made the appt. months ago for an issue with my hip. I am hoping he will know what can be done...

    In the meantime- anyone have any suggestions or similar experiences? Should I be in bed with it elevated? What about transfers, or even bending over to pick up stuff? Any advice would be greatly appreciated.

    BTW, I'm a T12/L1 para, have recently been told I have osteopenia...



  2. #2
    Moderator jody's Avatar
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    well what a nutty night you got to have.
    sorry about your broken knee cap. everybody breaking bones lately. I dont know what osteopenia.... is, but is there a way to feed your bones better? like do you get enough vitamin D? that helps you process calcium, magnesium, and something else that is important to your bones.

  3. #3
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    Yup, I just find new ways to keep things interesting....

    I guess osteopenia is a fancy word for weakening of the bones. Ironically, I've been taking 5,000 IU's of D3 for the past 6 months- also take a couple grams of vit. C and cranberry pills as well.

    I also joined the Y and was getting back into a workout routine as the past 2 years were not kind healthwise- last October they found a bladder stone the size of an orange that was keeping me infected! I'm hoping this is just a small bump in the road, but it kind of freaks me out not knowing if I'm making it worse... Gettin' old sucks!

  4. #4
    Senior Member jschism's Avatar
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    [QUOTE=BobG603;1444079]
    I guess osteopenia is a fancy word for weakening of the bones./QUOTE]
    You Are correct, Osteopenia is the weakening of bones. It is the stage before osteoporosis and hopefully at a point where it can be reversed to get bone density levels back to normal. It is important to have a doctor knowledgable in SCI when getting Bone Density checked, too. Since we are not able to stand, we will have certain bony areas of our bodies that will become weaker and that needs to be considered. getting plenty of calcium and vitamin D along with a good standing/weight bearing and exercise program will help. A blood test will determine those levels in your blood to detect deficiencies.

  5. #5
    Senior Member ryano's Avatar
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    Quote Originally Posted by BobG603 View Post
    Anyone ever break a knee cap? Well, after 28 years in a chair, I thought I've done it all, but this past weekend I managed to break my knee cap! I was transferring from my ATV to my chair, one leg on the chair, the right one on the ATV foot rest and I slipped- came down in a squat really hard, heard a crack. I checked for anything loose, didn't notice anything, and went hunting. When I got home, I noticed my knee was really swollen.

    Long story short, went to my primary doc who x-rayed it, sent me on to the ER to have an ortho doc look at it. I spent 6 hours last evening at the local ER- was seen by a NP who had more X-rays taken, confirmed it was fractured, but not quite all the way through... They did not call in the ortho doc (huh?). They hardly examined it at all- I asked him to look at the swelling, as I was concerned about DVT's... He ordered an ultrasound, which was thankfully negative. So they wrapped my knee in an ace wrap, charged me $50 and gave me the ortho's name for an appointment. My impression was that they didn't know what to do for a para with a broken knee cap (surprise)...

    Luckily, I have an appointment on Wednesday at Shepherd to see a Physiatrist- I had made the appt. months ago for an issue with my hip. I am hoping he will know what can be done...

    In the meantime- anyone have any suggestions or similar experiences? Should I be in bed with it elevated? What about transfers, or even bending over to pick up stuff? Any advice would be greatly appreciated.

    BTW, I'm a T12/L1 para, have recently been told I have osteopenia...


    Brush it off man...............we got a big hunt to go to in a couple weekends

    all kiddin aside though bud, I hope they can get you straightened out soon. I am not surprised in the least that the local small town hospital had no idea what to do for you.

    Call me later

  6. #6
    Senior Member fromnwmont's Avatar
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    cranberry tablets

    Quote Originally Posted by BobG603 View Post
    Yup, I just find new ways to keep things interesting....

    I guess osteopenia is a fancy word for weakening of the bones. Ironically, I've been taking 5,000 IU's of D3 for the past 6 months- also take a couple grams of vit. C and cranberry pills as well.

    I also joined the Y and was getting back into a workout routine as the past 2 years were not kind healthwise- last October they found a bladder stone the size of an orange that was keeping me infected! I'm hoping this is just a small bump in the road, but it kind of freaks me out not knowing if I'm making it worse... Gettin' old sucks!
    Bob: A tad off your subject but i was having kidney stone issues and like many heard cranberry was good for preventing them and UTI come to find out certain type of stone formations love the acid in cranberry!! I WAS adding to the formation they can test the stones to determine type.. After seeing them under a microscope they looked alien....Heal up and take care

  7. #7
    You should have been seen by an orthopedist, but until you get to see one, you need to keep your knee straight (not bent) to properly heal a patella fracture. If it is broken clear through, sometimes surgery will be needed. Casts should be avoided in favor of soft splints that can be removed for daily skin inspection.

    You are also more at risk for DVT, so also discuss with your physiatrist if you should be on prevention drugs for that for a while, and watch for any increased swelling.

    (KLD)

  8. #8
    Hi "BobG603,"
    Sorry to hear about your knee cap. Even sorrier to hear that a orthopedist wasn's called to see you while you were in ER. Keep the leg straight, immobilized, and elevated until you can see your physiatrist or orthopedist. You can get a soft neoprene velcro closure knee brace at the drug store or medical supply that will help you keep the knee immobilized. The velcro closure is important because you can loosen the brace to accommodate the swelling.

    When I broke the two bones in my lower leg, I spent the entire time it took to heal them in a soft boot cast to immobilize the leg. I have osteoporosis and the surgeon didn't feel that the bones were dense and strong enough to hold the screws or external fixation device he would normally use to set these broken bones. Depending on the level of osteopenia you have, you may have a similar issue.

    As an aside, add 1200 mg of calcium to the Vitamin D3 you are taking. You do not have to be classified with osteoporosis before starting to take prescription medication for your bones. If your osteopenia meets treatment criteria you may want to start Fosmax or one of the other bisphosphonates. How was your osteopenia diagnosed? Did you have at DXA scan or was it noticed in x-rays?

    All the best,
    GJ

    All the best,
    GJ

  9. #9
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    Thanks folks for the feedback, I really appreciate it. (Ryano- I'll getcha back for that!). I guess duct tape isn't going to cut it this time... dang!

    I'm now laying on the couch (typing is not fun laying on your back!). I also set up an appt. w/ an ortho doc first thing tomorrow morning. The "good" news is that while its broken, it is not yet in 2 pieces. which would require surgery.

    Trying not to freak out, but not knowing if I do something to make it worse is giving me the willies... and I'm usually not like that. But I'm alone and trying to figure out real basic stuff, like should I cath from couch, or get in the chair periodically?

    Also, I was wondering about driving- can't keep my leg straight and drive. I also still want to see the Shepherd Physiatrist, as it is my first appt., and it took 3 months to get! He's also a para, and I was really looking forward to seeing him. My primary doc discovered the osteopenia 6 mos. ago via xray, then ordered a density scan which confirmed it. I've heard some unsettling things about Fosamax and the like, and being on Medicare makes affordability an issue.

    I've been hesitant to add calcium supps, as my past few blood tests have shown slightly high calcium levels (had a thyroid test as a result).

  10. #10
    Quote Originally Posted by BobG603 View Post
    Thanks folks for the feedback, I really appreciate it. (Ryano- I'll getcha back for that!). I guess duct tape isn't going to cut it this time... dang!

    I'm now laying on the couch (typing is not fun laying on your back!). I also set up an appt. w/ an ortho doc first thing tomorrow morning. The "good" news is that while its broken, it is not yet in 2 pieces. which would require surgery.

    Trying not to freak out, but not knowing if I do something to make it worse is giving me the willies... and I'm usually not like that. But I'm alone and trying to figure out real basic stuff, like should I cath from couch, or get in the chair periodically?

    Also, I was wondering about driving- can't keep my leg straight and drive. I also still want to see the Shepherd Physiatrist, as it is my first appt., and it took 3 months to get! He's also a para, and I was really looking forward to seeing him. My primary doc discovered the osteopenia 6 mos. ago via xray, then ordered a density scan which confirmed it. I've heard some unsettling things about Fosamax and the like, and being on Medicare makes affordability an issue.

    I've been hesitant to add calcium supps, as my past few blood tests have shown slightly high calcium levels (had a thyroid test as a result).
    Try getting a referral to an Endocrinologist to discuss with him the appropriate treatment for osteopenia, i.e., how blood calcium is affected by oral calcium supplements, and the risks vs rewards of bisphosphonate treatments. Other treatments you could discuss include Reclast (once a year infusion treatment), Forteo (daily injectable) and Prolia (once every six month injections).

    All the best,
    GJ

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