u/Chou111111

A follow-up to my previous post.

At 10 AM Beijing time, I spent about half an hour giving my patient a detailed assessment. I found that aside from a minor tear in the posterior horn of the medial meniscus, a fracture of the medial tibial plateau, and a popliteal cyst, there were no other major issues. His AROM was normal. I advised him to follow medical advice and explained the fracture healing process in detail, which he readily accepted.

Then he explained how he got injured: initially, it was a chronic ankle injury. After about a month of rehabilitation, he was able to return to normal exercise. He went on a long hike and reported no abnormalities upon his return. Later, during a 3x3 basketball game organized by his company, he landed unsteadily during an aerial scrimmage, feeling a slight twist in his knee, but the discomfort quickly subsided. Three days later, he went running, and this time he started experiencing slight discomfort in the twisted area of ​​his knee, which only became truly painful during a frisbee game.

What amazes me is that during competitive sports, an unstable landing can easily lead to ACL rupture and meniscus damage, and in severe cases, even the terrifying triad. But he was very lucky; he only suffered a tibial plateau fracture because the MRI showed that his ACL was in very good condition, and his meniscus was only slightly injured.

I think he might have been in a bad mood on the day of the checkup, which is why he didn't want to follow the doctor's orders. Afterwards, I changed his method of using crutches to knee-bikes, which he found much more convenient than crutches.

I'm glad my previous post received a lot of advice, some admonishing me to protect myself, others criticizing me. But looking back, the idea in my head was incredibly reckless. I guess I haven't encountered any real trouble yet. Anyway, thank you for the criticism and corrections in the comments section of my previous post. After all, I'm not a fully mature physical therapist yet, and I will continue to work on it.

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u/Chou111111 — 10 hours ago

Would my method be too radical?

I am a physical therapist from China. I have a patient with a chronic left ankle sprain who has regained normal activity after some rehabilitation. However, recently while playing basketball, he suffered a tibial plateau fracture and popliteal cyst due to an unstable landing. The fracture line is long, and he doesn't usually experience pain. The doctor said he needs to use crutches for six weeks, but he's unwilling because his job requires prolonged standing. My idea is to have him stop using crutches. Is my approach correct, or is it too aggressive?

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u/Chou111111 — 3 days ago