Kneecap fractured into two parts

Patient

Q: Dear Doctor. I had an unfortunate accident where I fell from 2 level stairs and bruised my knee badly and had liason. A friend whose country I am visiting asked his family doctor to look at it an he said on examining, I do not have any fracture, just hematoma and should exercise, take anti histamine and anti biotics. This was exactly two weeks ago. Up until five days all was ok, until I started having problem with flexing my knee beyond certain point and incrimental pain began to happen. Finally decided to visit an orthopedic today afternoon and he recommend I do a straight leg raise test & I was unable to do it. He said my femur muscle could be atrophying and sent me for an xray to confirm. The devastating news was revealed that my kneecap is fractured and I will be needing an emergency surgery to repair it tentatively on Tuesday 2nd March 2010. To be honest, I do not have health coverage here but if all fails will have no choice but to come up with the money selling some of my personal assets at home. Please as physicians and orthopedic among your team if I decide to go back home tentatively in two weeks from now and get surgery done after that, will my recovery be unattainable. The orthopedic doctor I met today says it will have irreversible consequences & maybe I wont be able to flex my knee ever again if I wait that long. I do not want to gamble with my knees at the same time in a catch 22 phase. What would you recommend sir/madam? Is there way I can possibly buy time tops two weeks with medication, therapy et al and do the surgery back home. Please advise accordingly and thank you very much. Regards.

Doctor

A:   The nature of your injury requires immediate surgical repair to ensure the best possible outcome. It is unwise to wait too long to have the repair done as a complication of a knee cap fracture is an inability to fully extend the leg. Based on your description, you are already having significant pain and decreased mobility. If you are unable to have the surgery done where you are then I suggest you return home as soon as possible to do the surgery.

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