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efreysson
11-03-2016, 06:50 PM
My WIP has a character taken prisoner, and both his kneecaps broken to prevent him from escaping. By the time he appears in the story he has been in this state for four days, being forced to serve as a group's pilot.

Is a person sort-of able to stagger around with broken kneecaps, if given support? Are there any other health hazards, besides "This really hurts!"? Or would the pain subside after a while?

Prince Anpiel
11-03-2016, 07:00 PM
I am no doctor, but yeah this would be significantly worse than severe pain. I have seen a lot of knee injuries in my family.
The pain would get so much worse if you tried to stand that you would be incapable of staggering around if both knee caps were busted.
If you are not careful bone can be infected when injured too.
Bone chips can get moved into veins and kill the crap out of you.
That is going to heal really funny and he is never going to walk particularly well. It will also heal all full of arthritis and crap.
Really your hero can be saved by a convenient plot, but generally speaking his physical life has been ruined.

Lauram6123
11-03-2016, 07:07 PM
This is coming from Radiologist husband:

It would be difficult to walk because you couldn't forcibly extend your legs. You'd have swing each leg forward from the hip, which would be very difficult to do with both of them broken. This person would basically have to be supported on both sides or carried around to go anywhere.

It would hurt badly, of course, but perhaps after a few days, the brain might not perceive it as acutely.

jimmymc
11-03-2016, 07:41 PM
Pilot... as in flying an airplane? Not with broken knees. All four limbs are busy in the cockpit.

efreysson
11-03-2016, 10:20 PM
If you are not careful bone can be infected when injured too.
Bone chips can get moved into veins and kill the crap out of you.

Is this something that reliably happens if a fracture is left untreated, or can I skip this?


Really your hero can be saved by a convenient plot, but generally speaking his physical life has been ruined.


Pilot... as in flying an airplane? Not with broken knees. All four limbs are busy in the cockpit.

Well, to clarify: The victim of this is a bandit who tries to rob the wrong goddamn people, and they make him fly their spaceship. :)

Maryn
11-03-2016, 10:47 PM
I apparently had two broken ribs as a child and this didn't happen, so I presume you can safely skip that complication.

(The ribs healed by creating this big lump of bone over the injury site. Makes fitting a bra loads of fun!)

Prince Anpiel
11-04-2016, 04:51 AM
I apparently had two broken ribs as a child and this didn't happen, so I presume you can safely skip that complication.

(The ribs healed by creating this big lump of bone over the injury site. Makes fitting a bra loads of fun!)

Joints are different. These are going to heal in a much less healthy way than ribs would.

MaeZe
11-04-2016, 05:15 AM
The broken kneecap is not the problem. The problem is the kneecap is integral to the connection between the muscles (quads) in the front of your thigh to your tibia. As radiology hubbie of Laura points out, "It would be difficult to walk because you couldn't forcibly extend your legs."

Kneecap functions like a lever. (http://yourfunctionalhealth.com/why-do-we-have-knee-caps-anyway/)
In fact, it actually serves a very important function–it makes your quadriceps muscles (on the front of the thigh) more effective. The tendon of the quadriceps muscle crosses over the knee joint, attaching on the leg just under the front of the knee. When the muscle contracts, it rotates the knee into extension by pulling up on the lower leg. Because the patella lies right between the tendon and the knee, it positions the tendon farther away from the point of rotation than it would otherwise be. Just that little bit of increased distance imparts a major mechanical advantage. It’s simple physics–

RKarina
11-04-2016, 07:16 PM
Pilot... as in flying an airplane? Not with broken knees. All four limbs are busy in the cockpit.

This exactly.

Someone may be able to function through a whole lot of pain... but as others have noted, the knee caps are integral to the function of the leg muscles, and a pilot is using both hands and feet to operate a plane.

Twick
11-04-2016, 07:27 PM
Is this something that reliably happens if a fracture is left untreated, or can I skip this?





Well, to clarify: The victim of this is a bandit who tries to rob the wrong goddamn people, and they make him fly their spaceship. :)

If it's SF, why not have them inject him with something that temporarily paralyzes his legs? Then you can technobabble whatever you need, and can make it as painful or not as required for drama and practicality.

Beachgirl
11-05-2016, 03:55 AM
I can speak from experience, having actually broken my kneecap about a decade ago. Walking is not an option. Yes, it's extremely painful to try - which I did - but the knee just simply will not work. Trying to put weight on that leg was bad enough, but when I tried to walk that leg crumpled. Once the knee was stabilized and I was in a full leg brace - non-flexible from top of thigh to ankle - I could hobble around. If you want your character to be somewhat mobile, I'd have him use something that would work as a full stiff brace.

Roxxsmom
11-05-2016, 04:16 AM
I saw a display in the Smithsonian a few years back that showed some of the skeletons from an early colonial town in what is now the eastern US. Some of the people had broken bones that had healed without being properly set, but their limbs didn't heal straight. They looked worse than these healed bones (https://upload.wikimedia.org/wikipedia/commons/3/3a/Paleopathology%3B_Human_femurs_from_Roman_period,_ Tell_Fara_Wellcome_L0008764.jpg) from the Roman era. There was at least one skeleton who had had a bone infection that they'd recovered from, but it left permanent damage. There's little question that these people were disabled for the rest of their lives, and likely experienced chronic pain.

You know how they set someone's broken leg or arm in books and TV shows that take place in the old days? They get the person drunk maybe, and pull the limb straight, and they pass out, but it heals okay after it's splinted? That's not a likely outcome, except with the cleanest and least displaced breaks. There's a reason why, in the earlier 20th century, they put people in those traction apparatuses, and today they often put pins or plates in broken bones to get them to heal right. There were relatively skilled surgeons, even back then (and they had interesting devices for producing traction, even in the renaissance), but the lack of safe and effective anesthetics and disinfectants made surgery on broken limbs (and the outcomes of compound fractures) rather iffy.

I'm guessing a person with shattered kneecaps would survive, but they'd be unable to bend their knees after. And they'd be in excruciating pain for quite a while. Even the initial inflammatory and soft callus formation process of bone healing can take weeks to resolve (and that's just the start of healing), so I don't see this person flying an airplane or doing anything else that requires much movement of their limbs.

GeorgeK
11-05-2016, 02:04 PM
http://orthoinfo.aaos.org/topic.cfm?topic=A00523

It depends on the fracture. It's a sesmoid bone and not attached to other bones so it's possible that it might just be extremely painful but still technically stable enough for walking and would eventually heal on its own

mrsmig
11-05-2016, 04:01 PM
I cracked my right patella back in the eighties when I fell on it during rehearsal for a show. It swelled up and was painful enough to make me limp badly for a couple of weeks. I was a poor actress without insurance so I told myself it was just a sprain and soldiered on without seeing a doctor. Six months later I was dancing at a party when the leg simply gave out on me. That made me decide to go to the doctor, who took x-rays and informed me I had a partial ligament tear and oh, by the way, the patella I'd fractured in the previous fall had healed up nicely. So it depends.

I would think, efreysson, that your character's injuries would be a lot worse, since the injuries are intended to cripple him and in that case, probably involved multiple blows.