Knee > Fractured Shinbone > Treatments

   Closed Reduction and Casting

Home Recovery

If your fractured shinbone is set without surgery and requires a cast, here is what you can expect and how you can cope with a cast immobilizing your leg:

   The first concern is to monitor swelling for the first 48 hours while wearing your cast. If your swelling decreases dramatically, the cast may become too loose. If swelling increases, circulation can be dangerously cut off. In both cases, you should usually see your physician for a new cast.

   Keep your plaster cast dry. Wrap it in a plastic shower bag whenever you may come in contact with water. As with most knee injuries, treat with R.I.C.E. (Rest, Ice, Compression, Elevation). You may or may not be able to put some weight on your leg, depending on your physician's recommendation. Wrap ice into a well-sealed plastic bag and drape around the cast at knee level for 20 to 30 minutes, two or three times a day.

   Elevate the injured leg above heart level to help blood drain towards your body. It often helps to sleep with pillows under your ankles.

   Expect mild pain for about 10 days. Take pain medication as prescribed by your physician.

   Move your toes as much as possible to help circulate blood.

   If you develop a rash or irritated skin around your cast, call your physician.

   If you notice wear or discomfort, contact your physician as early as possible. In general, do not try to "grin and bear it" if discomfort does not go away within a few days.

Straight leg raises, which exercise the thigh muscles (quadriceps), usually are recommended after one or two days. To avoid complications, only your doctor should remove the cast with a special vibrating cast saw. In most cases, the cast is removed after four to six weeks.


   Recovery-proof your home

   When to call the doctor after surgery

Rehabilitation [top]

After your cast has been removed, your physician may recommend physical therapy to help strengthen the muscles around your knee and to help insure your knee's range of motion. Though everyone's rehab program is slightly different, physical therapy for a fractured kneecap follows a general pattern. Range of motion exercises are extremely important. Movement may be painful at first, but it is important to not allow the knee to stiffen. Rehab progresses to resistive exercises ­ those involving weights ­ to keep the muscles around your knee strong. These will start with minimal weights until about 12 weeks after surgery. You should then be able to start bearing weight as tolerated. You should eventually be able to resume functional activities like stair climbing, single leg support, swimming, and driving. You will be able to begin more vigorous activities as your kneecap heals and your leg gets stronger.


   Knee strengthening exercises: Shinbone fracture


Once your fractured kneecap has healed, building muscle strength around your knee can help you avoid further injury. Contact sports and activities increase your chances of re-injuring your knee. Many of the exercises and activities that are popular for fitness put stress on your knees. To prevent further knee injuries it is important to learn knee-sparing exercise techniques by dividing your activities into three components:

   Daily Living ­ The average person takes between 12,000 and 15,000 steps a day, exerting a force between two and five times your body weight on your knees. After a knee injury, take it easy on your knees during the day whenever possible to save them for activities and exercise. Avoid stairs when there is an elevator, take the shortest path when walking, and consider wearing athletic shoes designed to absorb shock.

   Muscle Strengthening/Conditioning - Activities themselves are not a substitute for conditioning. It is essential to adhere to the muscle strengthening program you learned in rehab throughout the remainder of your life. The best strengthening programs are low-impact and non-weight-bearing, like stationary bikes and certain weightlifting programs, so that the knees do not have to absorb shock.

   Recreation ­ Your sport or activity of choice helps maintain mental and physical well-being, but it is not a conditioning program. Sports that require twisting and quick direction changes put great strain on your knee.

A discussion with your physician or physical therapist can help determine the appropriate exercise program and activity level for you.

PAIN [top]

A small amount of pain is normal during physical activity, but if you feel so much pain in your knee to warrant taking a painkiller before an activity, you should consider cutting back or stopping. Do not play through the pain after a fractured shinbone ­ it may be a sign that your activity is putting too much stress on your knee.

Closed Reduction and Casting
   Home Recovery
Open Reduction and Internal Fixation
Closed Reduction and External Fixation
Limited open Reduction with Internal/External Fixation
Arthoscopic-assisted Reduction with Internal/External Fixation

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