Ever heard of an occult fracture?
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2010-03-15 11:42 AM |
New user 12 | Subject: Ever heard of an occult fracture? Hi all, |
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2010-03-24 11:43 PM in reply to: #2726908 |
Veteran 314 SoCal | Subject: RE: Ever heard of an occult fracture? it's more commonly known as a 'Bone Bruise.' it's something that often happens with a hyperextension or plant/and/twist type of injury to the knee (or also with a varus or valgus directed force, in more medical terms.) your injury "hyperextended to the inside" is known as a valgus injury and can injury the MCL and/or the ACL (especially if there's a twisting component to the injury.) these bone bruises come from basically the same type of forces/mechanism as an ACL, MCL or LCL (or posterolateral corner) injury ranging from a mild sprain to a complete tear of any or all ligaments. basically it's not a very *serious* injury, per se, but it is quite painful and most people find it takes nearly 3 months for their knee to feel better. we tend to recommend 2 or so weeks with crutches and weight bearing only touchdown, progressing progressing to active range of motion exercises, with weight bearing as tolerated soon after that. i wouldn't generally say this will put you "out" for 3-5 months, but i am not your physician nor have i examined you or seen your imaging studies. this injury will hurt for a couple months, and recovery after the very initial couple of weeks is usually dependent on how much pain a patient has. these bone bruises heal just fine, usually, and healing is faster in younger patients who don't smoke and are healthy. (uh, triathletes?) just some basic info from your friendly ortho resident here .... hope i helped a little bit. sorry i can't be more specific on when you should expect to be back in the game. best of luck in your recovery. |
2010-03-25 9:14 AM in reply to: #2726908 |
Extreme Veteran 1074 | Subject: RE: Ever heard of an occult fracture? I thought you were talking about groups of witches splitting into factions. |
2010-03-25 10:05 AM in reply to: #2746927 |
Pro 5011 Twin Cities | Subject: RE: Ever heard of an occult fracture? I'm not sure that's entirely correct... as far as I understand it, an actual "bone bruise" only involves the marrow, whereas an occult fracture breaches the osteochondral surface or the cortex of the bone. Both injuries are "occult" in that they do not show up on the xray, but there is a distinction. (Although I think it's one that is not always made.) |
2010-03-31 1:42 PM in reply to: #2746927 |
New user 12 | Subject: RE: Ever heard of an occult fracture? Novas, thanks very much your feedback. When the Ortho explained all of this at my last appointment it sounded so odd, almost rediculous, (and embarassing) that a "bone bruise" could cause this much swelling and pain. It makes me feel better that your explanation of the sutation is almost dead on with his diagnosis. At this point I think I've excepted that the HIM is out and I might as well work on swimming as much as possible while that's about all I can do. I have a follow up next week. I'm really hoping that he says I can get back to riding. It's funny, I've worked so hard for the last couple of years to learn the proper swimming technique. Now all of the sudden I've got to teach myself to swim without kicking since my knee doesn't really bend. Guess it should making learning a two beat kick much easier when I can finally start kicking again. |
2010-04-01 6:05 PM in reply to: #2726908 |
Champion 7704 Williamston, Michigan | Subject: RE: Ever heard of an occult fracture? I'm kind of confused as to if they dx'd it as a fracture or a bone bruise. I have watched radiologists change their nomenclature of these injuries over the last few years and its been intersting to watch the primary care guys first completely dismiss the bone bruises and then completely freak out over the 'fracture' nomenclature when they look exactly the same on MRI. I usually don't call it a fracture unless there is a fracture line. Part of it is a nomenclature issue but regardless to what they call it you had an injury to the bone. Since MRI technology is ever evolving and we didn't have it as it exists today 30 years ago no one can really tell you the long term meaning of the injury. We know lateral compartment bone brusies and ACL injuries typically go hand in hand. At any rate certainly a period of non weightbearing is in order and a longer period of no running is in order. These are not visualized on plain films so I would get a new MRI about 6-8 weeks after your injury to be sure its resolving. They can take up to a year to heal. (I know you don't want to hear that) You MAY be running in 3 months. Swim, bike aqua jog. |
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2010-04-02 9:32 AM in reply to: #2764044 |
New user 12 | Subject: RE: Ever heard of an occult fracture? Thanks very much Socks. I've been wondering about ACL damage as well. The doc ruled it out but the majority of my pain (other than the throbbing in my thigh) is right in the middle of my knee just slightly under the knee cap. I go back in a week for a follow up. I've officially been on crutches for about 5 weeks. This week is my first week of 10% weight bearing. So, far it's not too bad. I'm really hoping that the doc will say I can start biking again next week. |
2010-04-04 7:58 PM in reply to: #2764955 |
Champion 7704 Williamston, Michigan | Subject: RE: Ever heard of an occult fracture? TriDude2 - 2010-04-02 10:32 AM Thanks very much Socks. I've been wondering about ACL damage as well. The doc ruled it out but the majority of my pain (other than the throbbing in my thigh) is right in the middle of my knee just slightly under the knee cap. I go back in a week for a follow up. I've officially been on crutches for about 5 weeks. This week is my first week of 10% weight bearing. So, far it's not too bad. I'm really hoping that the doc will say I can start biking again next week. Find out where it is and report back Hope you feel better soon |