Patient: Description of the condition (onset, main symptoms, hospital visited, etc.): October 31, 2011 afternoon fell knee knee, at that time the knee swelling pain, unable to walk the same night went to the hospital to take a film, at that time did not find serious situation, but 10 days later still swelling pain, can not go down, and went to do MRI and CT examination, found patella fracture, ligament damage, meniscus degeneration, and a large amount of fluid, and now 4 weeks, still swelling pain, when can I walk, how long to go down, how much? The patella was found to be fractured, the ligament was damaged, the meniscus was degenerated, and there was a large amount of fluid, and it was then fixed in a plaster cast, and it has been 4 weeks now, but it is still swollen and painful. Doctor: Hello, this kind of injury early strict braking, affected limb elevation, appropriate cold compresses and pressure is very important, I think you did not pay attention to these points after the injury, try to early activity, so aggravated the original injury. From the imaging report analysis of more injuries, but the degree is not very heavy, strict cast fixation, limb braking for more than 6 weeks should help, bone and soft tissue of mild damage often need to have patience to give enough brake fixation time can gradually recover, while the affected limb elevation is also very important, I do not know whether the above points you have given sufficient attention and implementation. At this stage, if the joint swelling and pain are still obvious and accompanied by local redness and heat, you should also rule out infection. If not, please go to your nearest hospital for examination. In addition, please upload imaging data for further diagnosis if possible. Patient: Thank you very much for your very detailed reply. I went to the hospital 5 hours after the fall and had x-rays taken, but nothing abnormal was found and no braking measures were taken. However, 10 days later, I still had swelling and pain and could not go down to the ground, so I went for an MRI and CT examination and found multiple injuries such as patella fracture, which was then fixed in a plaster cast until now, but the swelling and pain are still obvious, and recently the injured area is hot and itchy and has a red rash. I have not had any abnormalities in my body temperature recently, nor have I had any blood tests, so I don’t know if the wound is infected, but I would like to ask the doctor to give me further treatment advice based on my recent condition. (Note: I have a closed fracture with no trauma, but I had polio in this injured leg and lost motor function, does this also affect recovery?) Doctor: Hello, previous polio can lead to loss of innervation and dystrophy of the limb, which can have an impact on recovery. Local swelling and rash should be excluded from skin allergies to bandages, excipients, etc. In addition, the swelling should be clarified as to whether it is of intra-articular or subcutaneous origin. We recommend that you consult your nearest specialist for further clarification of the above issues. In the present case, we recommend that you continue to apply brakes and elevate the affected limb. Doctor: Hello, I have read the information. The photo is not very clear, but the diagnosis can be clear, patella fracture, knee joint large amount of fluid, your patella itself is low patella, but does not affect the healing, must brake fixed enough time to facilitate fracture healing. Please refer to the aforementioned recommendations for further consultation and treatment. The orthopedic department of Hebei Provincial Hospital is at a high level, and we recommend you to follow up with your nearest doctor. Patient: Thank you, Dr. Li. Is my injury serious? Is the current conservative treatment of plaster fixation feasible? How long do I need to brake and immobilize before I can move around? Can I massage the injury now? Doctor: Hello, in terms of your patella fracture, the treatment of cast fixation should be appropriate, but the healing of the fracture takes at least three months, and the fixation should be at least to six weeks, the specific time of removal depends on the review, your radius fracture should also follow this principle, massage is not recommended, braking elevation and minimizing going to the ground should be more helpful. Patient: Thank you, Dr. Li, for your many replies. I am afraid that if the braking time is too long, it will be difficult to restore the flesh and bone to its original position, which will make the residual leg more difficult to move. Doctor: Hello, the restoration of limb function must be based on the healing of the fracture and structural integrity, the skin of the hair will not be attached! If the fracture and the soft tissue around the joint are not fully repaired, it is impossible to talk about the future recovery of joint function. It takes at least 3 months to fully repair a bone and joint injury, and recovery in cases where conservative treatment such as plaster fixation is taken depends entirely on whether braking is reliable, which is different from the recovery process in patients with surgical internal fixation, so you must be patient. After the fracture heals, there are various means to help restore joint function, but fractures involving the joint will definitely have a loss of joint function after the injury, regardless of the treatment modality, which you should be fully aware of.