dislocated knee. fluid around knee. no fracture or break? help.

[dais0913]

Hey everyone. Hoping for a little big of advice. Or if anyone has experienced anything similar.

Last night my 5 year old son. Banged and trapped his leg really badly.

His kneecap was totally out of place. When I tried to see if he could bend it. It popped and went back into place.
I still have no IDE how I wasn't physically sick.

Anyway since then he hadn't been walking on it. Or limping. And Complaining of pain.

I took him to a and E first thing this morning.

The gave him a xray and said they couldn't see any fractures or breaks. But there was a large amount of fluid around his knee which indicates something.
So they gave him a bandage and crutches along with painkillers. And we have to attend the fracture clinic in the morning.

Hrs still not putting weight on his leg. Can't use his crutches and still complaining if it being sore.

I should also mention the hospital definetly think he dislocated it but when I moved it. It popped back into place itself.

I'm just wondering what the fluid could be.
If there was no fracture. Why does he have to attend the fracture clinic.

Why is he still so sore. And why can't he put any weight on it at all.

Dear OP,

I have dislocated my knee cap three times so I can sympathise greatly with your DS. The knee cap popped back into place because the muscles around the knee cap pulled it very hard back into place. This is quite common following a knee cap dislocation. The fluid is the same kind of fluid you would get if you sprained your ankle. It is intended to protect the area and also to get white blood cells to the area to aid healing. The fracture clinic is the right place for him to attend even though he hasn't broken anything. This is because that is where you see the orthopaedic (bone) Dr's which he will need to do for follow up and to access physiotherapy should it be necessary. A kneecap dislocation is a significant injury and will cause pain. I am not at all surprised he can't put wait through it yet as it needs time to heal, for the ligaments and muscles to strengthen and for him to build confidence in putting wait through the leg. He is young and should heal quickly so don't worry too much.

Thanks for replying.

The Dr today said that the fluid around his knee means something isn't right.
I just felt like he wasn't explaining himself to me very well.
He kept saying he could have a fracture. Even tho they couldn't see one.

Will he be put in a cast tomorrow to help with the healing of the dislocation. Or just be kept in the tubi grip. X

A dislocation is a nasty injury in its own right, so it will be very swollen and painful even if there is no fracture. The soft tissues and ligaments will have been stretched and are just starting the healing process. Get him to stay off it for a few days, give regular Calpol or similar for the pain. You could try icing it too. The early management would be very similar either way.

I have known them to both cast post-dislocation, or sometimes use a splint (both times no fracture). The fracture clinic will likely review in a couple of weeks and decide from there how to continue to manage it and whether they feel further x-rays/scans are needed. Just to bear in mind, xraying young children repeatedly is not ideal, so they may play it safe with the management, just in case.

He may have a plaster cast or a brace fitted to reduce movement while the initial recovery occurs but th evidence for and against immobilising the leg is unclear. Give his age though the Dr may prefer to immobilise as at that age they can be difficult to keep still and not move in ways that may not be helpful. Every time my kneecap has dislocated I have had significant swelling around the knee afterwards so the swelling doesn't necessarily mean something out of the ordinary is happening.

I think what I'm more confused about. Is the fact it's not majorly swollen. And the fact the have said he needs to be seen at the fracture clinic tomorrow due to this fluid he has.
X

He should be seen in the fracture clinic anyway as soon as possible after the injury. Unlike other out patients clinics you usually get appts in the fracture clinic within a day or two of the injury so I don't think that is too much to worry about.

Tbh, the ortho doctor tomorrow will have a much better idea of how best to manage the injury than the doctor in A&E. It's normal practice to refer on to ortho in this situation, even for "just" a soft tissue injury. They understandably don't want to risk missing something so get a specialist to review. Dislocations are always reviewed by an orthopedic consultant

See the dislocation. If there is no fracture will they just allow that to heal on its own. Even tho its back in place now x

Yes, the soft tissues should heal on their own in time. They will probably review again in a month to 6 weeks and maybe again a few months after that to check that things are progressing well, and there has been no repeat dislocation. They may well send him to physio at some stage to help get his movement and muscle strength back. Kids usually bounce back though!

5yo's are too young for crutches, you need a little zimmer frame

Thanks ks for all your help.
Just been reading up on growth plate fracture ect. So a bit worried that it's something they haven't picked up. And worried how he's supposed to be mobile when he can't walk. I also have a 19 month old and I'm on my own. So carrying him is proving rather difficult :(

Do you still have a buggy he will fit in ?

or you can hire a small wheelchair from the Red Cross