Knee and Calf Pain After Fracture: Military Service Implications

Q: Knee and Calf Pain After Fracture: Military Service Implications

Hello： Due to the insufficient information provided regarding your actual condition (the term "calf angle" at 0 degrees is not a professional orthopedic medical term), we recommend that you visit our orthopedic outpatient clinic for a lower limb X-ray examination and a comprehens

Knee and calf pain?

Hello, doctor.
I fractured my knee last year, specifically a patellar fracture.
I have had O-shaped legs since childhood, and after walking for long periods, my knee and calf often feel sore.
Since the fracture, the area around my patella has been particularly painful.
After joining the military this year, I have to walk and stand guard every day, and the pain in my calves and knees has worsened compared to before.

I found a standard for physical assessment in the military regarding alternative service: "Deformity or malunion of the femur in the lower limbs with a curvature greater than ten degrees but less than fifteen degrees; tibial varus greater than five degrees but less than ten degrees, or tibial valgus greater than five degrees but less than ten degrees, or internal rotation greater than five degrees but less than ten degrees, or external rotation greater than ten degrees but less than fifteen degrees, or anterior-posterior bending greater than ten degrees but less than fifteen degrees." The standard for exemption is: "Deformity of the femur or tibia exceeding the alternative service standard or associated with significant related joint pathology."
I measured the angle of my calf at the hospital, and it was 0 degrees.
According to the doctor, the typical angle for a person is about 5 to 7 degrees.
Therefore, I would like to ask the deputy director if my condition meets the criteria for alternative service, specifically being greater than five degrees.
Since I was born in 1980, if I could be reclassified under alternative service, I could be discharged as a supplementary soldier.
I hope you can help me with this question.
Thank you very much.

Xiao Feng, 20~29 year old female. Ask Date: 2005/04/22

Dr. Shi Qiming reply Orthopedics

Hello: Due to the insufficient information provided regarding your actual condition (the term "calf angle" at 0 degrees is not a professional orthopedic medical term), we recommend that you visit our orthopedic outpatient clinic for a lower limb X-ray examination and a comprehensive physical examination.
This will allow us to measure the correct angle to serve as the basis for your military service medical re-evaluation.
Thank you!

Reply Date: 2005/04/22

More Info

After a knee fracture, particularly involving the patella, it is common to experience ongoing pain and discomfort, especially if there is a pre-existing condition such as O-shaped legs (genu varum). The pain you are experiencing in your knee and calf, particularly after engaging in activities such as marching or standing guard during military service, can be attributed to several factors, including the nature of your injury, the biomechanics of your legs, and the physical demands of military training.

From a medical perspective, the pain you are experiencing could be due to a combination of factors:
1. Post-fracture Pain: After a fracture, it is not unusual for the affected area to remain sensitive for an extended period. The healing process can lead to stiffness, swelling, and discomfort, especially in the knee joint, which bears significant weight and stress during activities.

2. Biomechanical Issues: Your pre-existing O-shaped legs may contribute to abnormal stress distribution across your knee and calf. This misalignment can exacerbate pain during physical activities, especially those that involve repetitive motion or weight-bearing.

3. Potential Complications: If the fracture has not healed properly or if there are complications such as malunion (where the bone heals incorrectly) or nonunion (where the bone fails to heal), these can lead to chronic pain and functional limitations. Additionally, the presence of post-traumatic arthritis is a risk after joint injuries, which can further contribute to pain and stiffness.

Regarding your military service implications, the standards for military fitness and the criteria for alternative service roles are indeed stringent. Based on the information you provided, it seems you are concerned about your eligibility for alternative service due to your knee condition.
According to the military's physical standards, if your lower limb alignment deviates significantly from normal (greater than five degrees in any direction), you may qualify for alternative service. Since you mentioned that your doctor measured your calf angle at 0 degrees, which is below the normal range of 5-7 degrees, this could potentially support your case for alternative service. However, the final determination will depend on a thorough evaluation by military medical personnel, who will assess your overall physical condition, including any functional limitations caused by your knee pain.

Here are some steps you can take to address your situation:
1. Consult with a Specialist: If you haven't already, consider seeing an orthopedic specialist who can evaluate your knee and calf pain in detail. They may recommend imaging studies, such as X-rays or MRIs, to assess the healing of your fracture and the alignment of your bones.

2. Physical Therapy: Engaging in a structured physical therapy program can help improve your knee function, strengthen the surrounding muscles, and potentially alleviate some of the pain you are experiencing. A physical therapist can tailor a rehabilitation program to your specific needs and limitations.

3. Documentation: Keep thorough records of your medical evaluations, treatments, and any recommendations from healthcare providers. This documentation will be crucial if you decide to appeal for a change in your military service status.

4. Military Medical Evaluation: Request a formal evaluation from the military medical board. Present your case, including your medical history, current symptoms, and any supporting documentation from your healthcare providers.

5. Stay Informed: Familiarize yourself with the military's medical standards and the process for applying for alternative service. Understanding the criteria will help you prepare your case more effectively.

In conclusion, while your ongoing knee and calf pain after a fracture is concerning, it is essential to seek professional medical advice and support. By addressing your physical condition and understanding the military's standards, you can navigate your situation more effectively and advocate for your health and well-being.

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