PCL Avulsion and Grade II+ MCL Tear


8 replies to this topic
  • Supernaut

Posted February 14, 2009 - 09:41 AM

#1

Dr. Mark--

I read about Sawblade's pcl avulsion fracture that he suffered a few years ago and he seems to have recovered fairly well w/o surgery.

Two weeks ago I wiped out on a sheet of ice on a Sierra Nevada logging road and doc says I have a PCL avulsion fracture on the tibia (minimally displaced) and a grade II+ MCL tear. I'm a 40 year-old male with a history of a few minor LCL injuries in the same knee over the past 10 years but otherwise the knee hasn't troubled me. The doc, who is a first-year orthopedic specialist, said tha that half the research says to operate, and half says to not operate and just deal with knee instability and other bearable problems as they arise later down the road. He said surgery is entirely up to me and offered no professional opinion on the matter. I asked for a second opinion but he said there is no time--the window is closing to operate and I have to decide in the next few days. I can certainly post radiograph/MRI images next week after I get them but I'd really like to know what your first thought would be about this injury. I don't expect you offer any absolute answer given the limited information I'm providing--I just wanted to know what an experienced doc would say about the first-line approach to take.

  • DrMark

Posted February 14, 2009 - 10:43 AM

#2

In my office, I would (assuming the ACL is ok) allow my patient to walk without crutches in a cylinder cast for one month. At one month, I would commense rehab, and expct by 10 weeks, a racer to be back in the saddle.
No surgery on this one.

The only time I fix the PCL is when it is associated with injury to the posterolateral ligaments. YOu seem to have dodged the bullet on this one.

  • Supernaut

Posted February 14, 2009 - 01:08 PM

#3

I really appreciate your input! I was calling around yesterday offering to pay cash for a phone consult with an experience ortho doc. My doc did not indicate posterolateral corner damage. He said if I decide against surgery I'll keep it in the full-length fabric knee brace w/ crutches for another 4 weeks before starting rehab. I like your idea of cast w/o crutches.

I still can't believe that you take the time to respond to everyone's questions--and I can't believe how helpful everyone on TT is--whatta forum!

Thank you!

  • Rice_Eater

Posted April 17, 2009 - 04:24 AM

#4

In my office, I would (assuming the ACL is ok) allow my patient to walk without crutches in a cylinder cast for one month. At one month, I would commense rehab, and expct by 10 weeks, a racer to be back in the saddle.
No surgery on this one.

The only time I fix the PCL is when it is associated with injury to the posterolateral ligaments. YOu seem to have dodged the bullet on this one.


Dr. Mark,

I am in the same situation as the rider above. I had a complete avulsion of my PCL ligament coupled with a tear to the MCL of my left leg. I was in a cylinder cast for 6 weeks followed by a brace for another 6. It is now 5 months post injury and I would am starting to ride again.

I feel I need some kind of extra support for my leg when I ride. I can't decide between two different types of knee braces:

The evs WEB KNEE BRACE
http://www.evs-sport...d=1&item_id=115

or the Don Joy Extreme Action Armor
http://jointhealing....es/extreme.html

I can't make up my mind. The evs Web Knee Brace seems to offer better all around protection has built in crumple zones to reduce the risk of breaking a thigh bone in the event of a hard crash. While the Don Joy Action brace seems to be better suited to a supporting a PCL deficient leg since the brace goes behind the lower leg.

Which do you think is the better choice for our situation: Non-operated on PCL avulsion with MCL tear?

  • DrMark

Posted April 17, 2009 - 06:56 AM

#5

Since I am in the midde of a study, I have no opinion to offer on knee braces.

  • Supernaut

Posted April 18, 2009 - 07:33 AM

#6

Wow--I am really looking forward to riding again--I'm 10 weeks out and am walking without a brace but I still need to build a lot of lost muscle back. Have you seen the Asterisk Cell? See this link: http://www.dirtrider...dex_braces.html

  • Rice_Eater

Posted April 19, 2009 - 10:18 AM

#7

Wow--I am really looking forward to riding again--I'm 10 weeks out and am walking without a brace but I still need to build a lot of lost muscle back. Have you seen the Asterisk Cell? See this link: http://www.dirtrider...dex_braces.html



I took an Asterisk Cell with me to show my doctor. HE said it would be great for an ACL injury, but is not suited to the support needs of a PCL injury.

Other than that, it looks like a great brace.

I'm still going back and forth between the Web Knee Brace and Don Joy's Extreme armor. I can't make up my mind. It looks liek the Web is a better riding brace, but the Don Joy is more targeted to a PCL injury.

  • Supernaut

Posted April 20, 2009 - 03:56 PM

#8

Interesting! If you don't mind, can you post your thoughts after you buy and use a brace? I've got about another month of rehab before I'll be shopping for a brace. I actually tried on an EVS Web and liked how simple it was to attach. Is your medical insurance going to pay for your motorcycle brace?

  • Rice_Eater

Posted April 21, 2009 - 01:25 AM

#9

Interesting! If you don't mind, can you post your thoughts after you buy and use a brace? I've got about another month of rehab before I'll be shopping for a brace. I actually tried on an EVS Web and liked how simple it was to attach. Is your medical insurance going to pay for your motorcycle brace?



No, unfortunately, my insurance will not pay for the brace. I have to cover it all out of pocket.

I was looking at the EVS Web and the POd MX and they look very similar. I could not find a head to head comparison of the two and chose to order the POD MX because it was $38.00 cheaper per leg and has a lot of good reviews online.

I am also ordering one of the Don Joy Armor braces for my injured leg which seems to be hurting more since I started walking down stairs normally. I do this a lot since I live on the fourth floor with no elevator. I'll be wearing the Don Joy for daily life till the leg strengthens and stops hurting all the time.

I decided not to use the Don Joy as a riding brace since both the POd and the WEB seem to offer better all around protection, and have been designed to lesson the chance of leg fracture caused by the brace acting as a fulcrum on your leg in an accident.

Since I will have both the Don Joy and the Pod I'll write up a side by side comparison and let you know what I think of them.



David L.





Related Content

Forums
Photo

What to do as a workout for Harescramble racer? by Fade


Dirt Bike   General Dirt Bike Forums   General Dirt Bike Discussion
  • Hot  63 replies
Forums
Photo

CRF250L- 1, Dog- 0 by razorbill


Dirt Bike   Make / Model Specific   Honda   CRF250 L/M
  • 4 replies
Forums
Photo

how much weight can your LRP lose? by jeffjcalweb


Dirt Bike   Make / Model Specific   Honda   CRF250 L/M
  • 5 replies
Forums
Photo

Mx training besides running by Ride_blue82


Dirt Bike   Dirt Bike Technical Forums   MX Riding Technique
  • Hot  59 replies
Forums
Photo

Stretch before or after excercise? by Bryan Bosch


General   General Forums   Health & Fitness
  • 9 replies
 
x

Join Our Community!

Even if you don't want to post, registered members get access to tools that make finding & following the good stuff easier.

If you enjoyed reading about "" here in the ThumperTalk archive, you'll LOVE our community. Come join ThumperTalk today!

The views and opinions expressed on this page are strictly those of the author, and have not been reviewed or approved by ThumperTalk.