How long after a patellar comminuted fracture can one start walking?

Written by Na Hong Wei
Orthopedics
Updated on September 21, 2024
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Patellar comminuted fractures generally require surgical treatment. If the surgery goes well, patients can start moving around with the aid of crutches one week after the surgery. Initially, changing positions is not allowed. Generally, patients can start by placing the toes on the ground two weeks post-surgery, followed by the middle part of the foot, and finally the heel. This progression occurs from two to six weeks after the surgery.

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Written by Wang Cheng Lin
Orthopedics
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Can a lumbar crush fracture cause paralysis?

Whether a lumbar burst fracture will cause paralysis mainly depends on the severity of the comminution and whether the fracture fragments protrude into the vertebral foramen, compressing the nerves. If it is simply a comminuted fracture and the fragments do not protrude posteriorly and do not compress the nerve roots, then it will not cause paralysis of the lower limbs. However, if the fracture fragments protrude backwards and compress the spinal nerves, or even damage the spinal nerves, the patient may experience complete loss of muscle strength and sensation in both lower limbs. In this case, emergency surgery is required to relieve this compression and reduce the pressure on the nerves, thereby alleviating the symptoms. If lower limb paralysis occurs, long-term oral medication to nourish the nerves is needed to help the nerves gradually recover. Therefore, whether a fracture can cause paralysis mainly depends on whether the nerve is compressed by the fracture fragments. If there is compression, it will result in complete loss of muscle strength and sensation in the patient's lower limbs. (Please take medication under the guidance of a professional physician.)

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Written by Na Hong Wei
Orthopedics
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Will a comminuted patella fracture cause limping?

Patellar comminuted fractures, as long as treated promptly and correctly, and if the surgery poses no issues, generally heal in about six months, thereby not causing any significant impact. Thus, there's no need to worry about limping. Limping usually means that when walking, one leg appears longer than the other. Under what circumstances can limping occur? If the difference in leg length is within one centimeter, it's imperceptible and won't have any effect. If the difference exceeds two centimeters, then there is a noticeable tilt in the lower limbs, and only then can limping be observed during walking; however, even if limping occurs, it is not severe. It just means that while walking, there is a tilt towards the shorter side. After treatment, patellar comminuted fractures have a complete chance of healing and once healed properly, it's almost like before the injury. Even in severe cases where the fracture is critically fragmented and requires removal, even without patellar replacement, by reinforcing the patellar tendon, it typically does not result in limping. It only impacts the strength in knee extension, possibly creating a mild impediment compared to the other side, and might make walking appear slightly abnormal, but it definitely does not lead to limping. Hence, patellar comminuted fractures do not result in limping.

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Written by Na Hong Wei
Orthopedics
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Is a comminuted patellar fracture serious?

Patellar comminuted fractures are usually quite severe because once the patella is shattered, it can no longer guarantee a smooth cartilage surface. Moreover, the more severe the fragmentation, the harder it is to restore smoothness. If the smooth surface is not well restored, certain conditions can arise. The first is post-traumatic arthritis, the second is patellar chondromalacia, and the third is patellofemoral arthritis. Therefore, patellar comminuted fractures usually require open reduction and internal fixation surgery. In this surgery, it is crucial to align the cartilage surface of the patella as accurately as possible, making the joint surface as smooth as possible, and then fasten it securely with wire loops or tension bands. If the patellar fragmentation is particularly severe, and it's impossible to restore the integrity of the cartilage surface, it may be considered to remove the patella. If feasible, a prosthetic patella can be installed. If not, the ligaments and joint should be repaired, and then functional exercises should begin three to four weeks post-surgery, although this method of surgery typically results in weakness in extending the knee on the affected side.

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Written by Na Hong Wei
Orthopedics
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How long does it take for a comminuted patellar fracture to heal?

If the patella is fractured into fragments, conservative treatment is usually not chosen, and surgical treatment is necessary. There are several surgical methods, but as long as the fixation is sturdy and the joint surface recovers well, normal life and work can generally resume in about six weeks. Typically, a follow-up at the hospital is needed in the fourth week or the twelfth week after surgery. If there are no issues at these check-ups, normal work and life can continue. However, the internal fixatives such as steel pins, wires, or memory alloy bone clamps should be removed within six months to a year post-surgery. It is generally recommended that the internal fixation devices be removed around thirteen months after surgery when the patella has healed well, and the knee joint function has been restored, allowing for a return to a normal life. So, for a comminuted patellar fracture, recovery to normal life typically takes about six weeks, and the internal fixation devices can be removed in about a year.

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Written by Wang Cheng Lin
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How long does it take to recover after surgery for a comminuted fracture of the humerus?

Generally speaking, the recovery time after surgery for a comminuted fracture of the humerus is about three months, but this can vary from person to person. If the patient is young, the healing of the fracture ends might be quicker, potentially achieving bony union within two to three months. However, if the patient is elderly, their healing might be slower, possibly requiring three to four months to achieve bony union. Therefore, it is necessary for patients with fractures to regularly take X-rays to observe whether the fracture ends have achieved bony union. Typically, they should visit the hospital to get an X-ray about every two weeks to check on the growth of the fracture ends.