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Dr Mark: Help with 7 year old's injury...

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My son is 7 years old. Last tuesday he banged both knees up pretty good on the trampoline whilst showing off a double backflip for the neighbor(in spite of my several warnings about the trampoline to begin with). He came down on the metal frame on both knees. According to him there were no popping sounds nor was there any twisitng of the knee. Nevertheless, when I got home from work his left knee was quite swollen and he was in considerable pain. I did my best to evaluate the knee and surrounding areas, but he was scared of the pain and not very cooperative( I am a physician and remembered a few basic exam techniques from an ortho rotation 10 years ago).

At any rate, I wasnt real concerned about the knee but more concered about a tib fracture/growth plate injury. I sent him out for x rays and off to his pediatrician the following day. X rays came back "inconclusive but possible tibial fracture". He sees an ortho tomorrow. He has steadily improved the past several days. He is getting around on crutches and says the knee feels better every day. The shooting pain has long ago subsided. I am a little concerned about a medial meniscus injury/possible ACL. I did not notice any excessive movement anteriorly of the tibia this evening, but I may be missing something more subtle since this is not my area of expertise. He cannot/will not completely straigten his leg yet but is gaining range of motion with each day. The swelling is much improved(outline of patella clearly visible now) but still noticeable. We have been RICE'in since the injury. I have been stretching him out daily and today began an exercise bike regimen. While stretching him out he complains of tightness behind the knee medially...it isnt pain he says just tightness.

He did 20 minutes this evening on the bike with no pain...in fact he was excited to get off the couch for a change. He will not walk on the leg yet but I see him moving it around much more and flirting with the idea of putting a little weight on it. I spoke with a friend who is an ortho but has not seen my son yet. His opinion was that if he continues to improve daily, all is well; he doubted it ws a fracture. If he is not off the crutches by early next week, he wants an MRI and is highly suspicious of a meniscus injury and/or collateral damage.

This could not come at a worse time for him...he is racing in two very big series and is poised to take first places in multiple classes. Thankfully his next race isnt for 4 weeks so we have time on our side...unless he needs surgery. Any suggestion? Thanks for your time...sorry for being so long winded, I just know from experience the more info the better.

Posner

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It doesn't sound like this was a very serious injury, by the way he is recovering.

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Thanks for the reply. This was the sentiment shared by my ortho friend as well. I have just never seen my son in as much pain as he was in the first 2 days following the injury...he doesnt cry very often and when I tried to move his leg at all he begged me in tears to stop. I will post up the report from our ortho. Thanks again.

Posner

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