Will a comminuted patella fracture cause limping?

Written by Na Hong Wei
Orthopedics
Updated on September 06, 2024
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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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Sequelae of comminuted fracture of the humerus

Regarding the sequelae of comminuted fractures of the humerus, in clinical practice, if treatment for humerus comminuted fractures is proactive and patients diligently engage in functional exercises without any nerve damage, most patients will not experience any sequelae. However, if treatment is improper, a series of sequelae can often occur, mainly reflected in the following aspects: First, if there is accompanying nerve damage that is very severe, it can cause patients to experience sensory disturbances or motor function impairments. Second, poor repositioning of comminuted fractures can lead to nonunion or malunion of the fracture, affecting normal functions of the patient. Third, long-term immobilization in the later stages can cause joint stiffness. When patients eventually start exercising, fear of pain may lead to insufficient exercise, resulting in very poor joint mobility, thereby affecting normal functions.

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Why can't it rotate five months after a comminuted fracture of the humerus?

Five months after a comminuted fracture of the humerus, the inability to rotate is due to the lack of early functional exercise post-fracture, leading to severe adhesions in the joint and upper arm muscles, which significantly restrict rotation. This condition can be gradually recovered through later functional exercises, slowly tearing apart the adhered muscles, and increasing the range of motion of the humerus. It is recommended that patients seek rehabilitation treatment in the physical therapy department of a hospital. Additionally, various physiotherapy methods can be used to improve local blood circulation, promote muscle healing, relieve joint and muscle stiffness, and methods such as electrotherapy and magnetotherapy can also be applied to assist in improving the rotational capacity.

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Written by Wang Cheng Lin
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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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Orthopedics
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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.

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Post-syndrome of comminuted femoral fracture

The main sequelae of comminuted femoral fractures are as follows: The first is a delay in healing and nonunion of the fracture ends. Due to the comminuted nature of the fracture, local blood circulation has been damaged, and even with surgery, it is difficult to restore circulation. This can lead to delayed healing and nonunion of the fracture ends, generally requiring observation for around one year. If fracture lines are still clearly visible after a year, this confirms a nonunion, necessitating further surgery and bone grafting to restore the healing of the fracture. The second, in cases of nonunion, is the possibility of plate fracture. Many patients, unable to endure extended bed rest, need to start weight-bearing walking. If the fracture ends have not healed and weight-bearing occurs, the body's full weight concentrates on the plate, leading to stress fractures of the plate and screws. Should such stress fractures occur, immediate surgical intervention is needed to replace the internal fixation.