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What Does My Lab Test Report Indicate?

Posted on Fri, 27 Oct 2017

Question: My mother got patela fracture, we consulted orthopedic who suggested for 20 days bed rest.She has alreadyd patela fracture 3 years back for which she has gone through surgery .Would like to share the x-ray and other reports for second opinion.

Answered by Dr. Dr. Gopal (1 hour later)

Brief Answer:
Wires , if causing problem , need to be removed.

Detailed Answer:
Hi I am Dr Gopal Goel Orthopedic Surgeon.
I have seen the x rays and if these are fresh X rays then they do not show any fresh fracture patella ,as far as I can make out.
Two wires from previous operation are protruding and if they cause any problem like pain or irritation ,then the wires should be removed.
Bed rest , in my opinion , has no role in fracture patella.
I hope this solves your dilemma. Please feel free to ask any other question.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Gopal (28 hours later)

Hi Doctor,

Thanks for the answer.
We took another x ray today.Please find the attached.She is unable to move/lift her leg on her own, should we give her complete bed rest for few weeks, do you see any fracture or bone density issue .These days we are hearing a lot about bone density issue in diabetic patients, could you please let us know if you suspect anything as such from xray.
Also we found her knee is warm and tender.Is this something to be taken serious.

Thanks

Answered by Dr. Dr. Gopal (5 hours later)

Brief Answer:
No fresh fracture seen.

Detailed Answer:
Hi
I have seen the X rays and the reports. With these X rays I do see a small chip in the inferior side of patella but that appears to be old piece only. All her reports are within normal limits.
There could be low grade infection since the knee is swollen and warm.
Bed rest may not do much good to her.
Bone Density ( weakness in the bones) has nothing to do with this and we need Bone densitometry to assess this. X rays are poor indicators of bone densitometry.
It requires clinical examination to know the problem at present. I would suggest re examination by a orthopedic surgeon ASAP.
Thanx

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Gopal (3 days later)

Hi Doctor,
Thanks for the reply we consulted an orthopedic.as you said if there is chirping in bone then does it cure with bedrest?

Answered by Dr. Dr. Gopal (6 minutes later)

Brief Answer:
No bed rest

Detailed Answer:
Hi
As I said earlier there is no role of bed rest in fracture patella. The chip , I said is probably old and needs no treatment.
Thanx

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Gopal (8 minutes later)

Thanks Doctor,
But she is unable to move or lift her leg on her own.what could be the solution for it?
Also the knee of fractured leg is always warm is it normal?

Answered by Dr. Dr. Gopal (5 minutes later)

Brief Answer:
Cannot say why she is unable to move or lift it.

Detailed Answer:
Hi
There could be multiple reasons for not being able to lift the leg , Fracture patella being one of them .Warmness is always there in any injury , the worrying factor would be redness and fever and increasing swelling. Please get an X ray pelvis with both hips AP view also.
If the problem persists , I suggest admission in a multi speciality hospital for diagnosis and management. What did your orthopedic Surgeon say?
Thanx

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Gopal (1 hour later)

Thanks Doctor
We consulted two orthopedic surgeons they are saying that there is a fracture and suggested bed rest for 15 days.also after 15 days if the condition is worse then surgery needs to be done.also one orthopedic suggesting there is bone density problem because of which there are extra tests done will share the reports

Answered by Dr. Dr. Gopal (4 hours later)

Brief Answer:
will wait for the reports.

Detailed Answer:
Hi
Doctors who have seen her are in a better position to tell about her condition. For Fracture patella which is displaced there is only one treatment- that is operation. For undisplaced # patella plaster cast is applied. To the best of my knowledge Bed rest is never prescribed for fracture patella since it does not help in any way.
Since X rays are not very clear about diagnosis I would suggest CT scan of knee to see the fracture.
Let us wait for the report of all the tests.
Thanx

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Gopal (2 hours later)

Thanks Doctor,
One removable knee brace has been given by doctor for preventing the knee from bending.Does knee replacement surgery helps to avoid further complications of this fracture?

Answered by Dr. Dr. Gopal (45 minutes later)

Brief Answer:
Knee replacement surgery is different .

Detailed Answer:
Hi
Removable knee brace is good enough for temporary use. It will relieve the pain and help in reducing swelling and assist in mobilization.
Knee replacement surgery is never done for fracture patella. Patella is partially replaced during knee replacement .
If she requires knee replacement then the problem due to patella will be helped, how much help, I cannot say at the moment.
Thanx.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad