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feck
05-22-2005, 01:58 PM
Hi all,

was performing jiyu-waza yesterday, using only some kokyu-nage's as technique's, using the one where my leg should go behind the uke and my arm accross the front, and then turn toward's them to knock them over. CRUNCH!!, fractured my knee and tore some ligaments, one of the most painful things i've ever experianced.

My concern is, is that when i went to hospital they gave me an X-Ray and told me about the fracture, which they then put in a splint and told me to return to the fracture clinic on Thursday. thats 5 days away an am worried about a few things, firstly is this to long to really treat a fracture, secondly my leg is not splinted completely straight, it has a kink at the knee and am worried that this could heal like this.

Should I not have been offered an MRI or CT scan to completely asses the damage before releasing me? Should my leg be held completely straight to promote correct healing?
Should I have been released from hospital at all so quickly (1& half hours turnaround)?

Has anyone else experianced something like this and how did it effect them returning to aikido? I know i should'nt be concerned with this last question, but more in healing my leg but to me this is part and parcel of my own way with dealing with the situation. The way i see it is if I cannot ever continue practicsing then what else can i not do?

All comments that are helpful and constructive will be greatly appreciated.

Thanks

feck
:uch:

Pauliina Lievonen
05-22-2005, 06:06 PM
That sucks! :( I'm afraid I don't have any advice, hopefully some of the medical people on the boards will read this and chime in. Anyway I hope you'll heal well and quickly!

kvaak
Pauliina

Janet Rosen
05-22-2005, 07:14 PM
Don't know what you mean by "fractured knee": femur, tibia, patella? Since nobody here can know what the problem is, nobody here can really second guess.
In terms of CT/MRI, well with the kind of injury that will injure both bone and soft tissue, there will be a lot of swelling and it is not unusual to defer a CT/MRI which looks at soft tissue until some of the acute swelling goes down. Treating a fracture first seems like a reasonable step. But also, I'd say, if you are uncomfortable with what has been done, go back and get seen by somebody else.

Lewis Johnson
05-22-2005, 07:36 PM
Wow, my first post here... Hopefully I won't make a complete idiot out of myself...

First off, sorry to hear about your injury. I know how screwed up that can make life. My mother has had a fractured knee recently following a car accident, about a year and a half ago now. So I've been there through her experiences. I am also a certified (but not practicing) EMT-1b, although this is just a little out of my scope of practice...

The slight bend in the knee is supposed to be that way. Full extension of a limb is anatomically speaking a hyper-extended limb. One reason why we're told to never fully extend our arm; if the joint is hyper-extended, there is no free play there for movement and it's broken rather easily. So, by keeping the leg in a bent position, it IS straight, and completely normal. Just the way it's supposed to be.

You weren't casted right away because of the swelling in your knee. The cast needs to be properly fitted, and as your knee begins to heal, the it'll shrink in size quite a bit. Same reason why your MRI/CT was likely postponed. But be sure to ask about it when you go in for your cast later. And be prepared... it'll be a full leg cast, and you'll have it for a good while. My mom was in her's for eight weeks. Have fun! :D And an hour and a half turnaround time at the hospital?! You should feel lucky, not concerned!!!

And, if I may ask also... what specific kind of break was it? My mom had a lateral condial fracture. I'm just curious... Hope I was of some help.

Sincerely,
Lew

feck
05-23-2005, 01:18 AM
hi people,

thanks for the responces so far. I'm sorry that i cannot be more specific as to my injury, this is because at the time of the hospital visit i was heavily dosed up with pain killers. The tiny bit I do know is when the ligament was torn or ripped it fractured the bone where the ligament was attached, literally ripping the bone away. I am pretty upset as you can imagine, in that i was training 5 to 6 times a week and was progressing pretty rapidly, until this happened.

My instructor at the time is trying to blame himself for letting the speed of the jiyu-waza get out of hand. But this was no body else's fault but my own, seeing as i was so enthusiastic about the training method and I myself was pushing my limits to the board.
I succesfully threw two ukes including the instructor before the injury and both throws went extremely smoothly, the last throw i think i just did not position myself correctly.

Anyway thanks again for the responses and please keep them coming.

The only training i will be getting for some while will be from this website.

thanks again people

feck.

Anat Amitay
05-23-2005, 07:08 AM
Hi there,
Sorry to hear about your injury, and hope the damage isn't too bad so you heal quickly.
As has been said above, you don't know the place of fracture so it's hard to say what type of treatment is best. Second, there are so many ligaments in the knee area, it depends how many are torn and if they are fully or partially torn.
If you feel unsure of the treatment up till now, you should go back and ask an expert to explain the details (you have the right to say you were pretty much out and couldn't understand everything the night you were there).
Healing takes time (sorry...) minimum 6-8 weeks for fractures and that's just to get the union between the bones. Full recovery is in one year when the bone reshapes and builds itself (time also depends on age- the younger you are, the better you heal, unless you have a break in your epiphisial plate- growth plate).
Since the knee isn't a stable joint, when you heal, you should go and take seriously the physiotherapy you get- if a ligament is torn, it will NOT grow back and you need to strengthen the muscles around the area to take part in stabilizing your knee- it needs lots of practice, especially if you want to go back to Aikido later on and not do any further damage.
I really hope it's not a really bad injury, take care and get well soon!
If there is anything else I can help with, I'd be glad to,
Anat

feck
05-26-2005, 11:07 PM
Hi people,

thanks again for all the responses so far. Yesterday I went to the fracutre clinic as instructed. I asked if MRI was necerssary and the the doctor agreed but would probably use a CT scan. Another doctor came in looked at my leg, then both left to confer. "Sorry why do they leave to confer?"
First doctor came back and insisted i need an operation (schedualed for Friday 3rd June) to fix my knee.

The diagnosis given was that i have a Tibial spine avulsion fracture with associated medial collateral injury and anterior cruciate injury. the operation will remove any exess blood and fragments, and will try to repair the TSA fracture and the rest.

Again after surgery a cast will never be set only another splint.
Part of the surgery will be exploratory to enable a better assumption of the condition of the knee, when told this i again requested a CT Scan to make things easier, but was denied because i was told that exploratory side to the surgery would solve all that.

Now like i've said before i am not at all medically trained, but would'nt a CT Scan help the situation and aid in surgery?

Thanks for everything so far and please keep the responses coming

feck :uch:

Janet Rosen
05-26-2005, 11:43 PM
No, the cat scan would not help and I don't know why you think it will. Based on the info as you have presented it, and understanding that I am trying to interpret that for you, not diagnose or second guess:
A fracture of bone is shown on plain xrays and is the primary issue requiring surgery (bleeding and fragments). They have to go in and soft tissue pictures are not going to change that.
The ligament damage does not show up on xray but can be inferred from manipulation of the joint. This tentative diagnosis could be backed up by scans...however:
1. with lots of blood and swelling and fragments, it might be too early to get a good sense of soft tissue situation and
2. Ct scans and mri scans are NOT foolproof. They rely on the machine settings and the biases and competency of the person using them. They are never as good as direct visualization. Any honest orthopedist will tell you that only going in and directly looking will ever tell the exact damage. And a really honest one will tell you that in some cases it may not be necessary (people with damaged ligaments, even totally torn ones, can rehab without surgery in some cases)
So, no, I don't see how or why a ct scan would "make things easier." If they are correct about the fracture, let them in there! Repairing the bone is way more important than applying an external cast to it.

awh
05-27-2005, 12:10 AM
Has anyone else experianced something like this and how did it effect them returning to aikido? I know i should'nt be concerned with this last question...

Why not? It's natural to wonder whether or not you will be able to keep on doing something that you love after an injury. I know that it's not the same thing, but I had to think long and hard before I decided to get corrective eye surgery, because I was concerned that something might happen and I wouldn't be able to return to flying.

Of course you didn't have the luxury of being able to think long and hard before deciding to injure your knee, but certainly you have every right to worry about what may happen with your Aikido.

- Drew

aikidoc
05-27-2005, 10:19 AM
Janet is right about the direct visualization. A worker's comp patient of mine fell into a hole and injured his knee. Scans were essentially negative. When he was scoped they found a subchondral fracture which needed surgical repair.

Your injury sounds like a torquing injury. The collateral ligament damage and cruciate damage need to be repaired to ensure your knee is stable. Since the avulsion fracture likely involves a ligament insertion it will also need to be repaired as well.

It is hard to say if it will affect your aikido-depends on age, surgeon, rehab, etc. Be patient it will take time. When I had medial meniscus surgery, it took over a month before I could ease all the way down in seiza. An understanding instructor helps.

Janet Rosen
05-27-2005, 05:08 PM
When I had medial meniscus surgery, it took over a month before I could ease all the way down in seiza.
Typical post-surgery rehab for an acl graft is--depending on surgeon/protocol--6 to 9 months before return to full activity.
If his main problem is the bone, and the ligaments turn out to be in decent shape, his rehab will be more a matter of rebuilding muscle and then some good balance and plyometrics but not as extensively the latter as if a ligament graft is needed.

feck
05-28-2005, 01:07 PM
Hi all,

Thanks again for all the responses so far.
One other thing seems to be bothering me at present, and that is the fact that when i stand up ( with the use of crutches and taking the weight on my good leg) my bad leg seems to fill with blood and feel inflamed. The leg actually turns a dark red after several minutes standing, it seems to me that the blood has no way of pumping back up the leg, until i elevate it again.

Is this usual?, or should i go back to hospital before my operation next friday?
Should I elevate my leg at all times until the operation?

Thanks again people

Darren

Janet Rosen
05-28-2005, 02:08 PM
Periods of elevation above the heart is generally recommended for any soft tissue injury w/ swelling. What you describe sounds like it is worth at least phoning them about. In general a question like that really should be directed at your medical team, NOT to a group of well meaning strangers.