Walking After Femur Fracture: When to Trust Your Recovery?

Issues with walking after a femoral fracture with retained intramedullary nails?

Hello Doctor, I underwent fixation with a femoral nail on my right thigh on November 14th last year and was discharged on November 17th.
It has been eight months since then.
I returned for a follow-up appointment on the 4th of last month and had an X-ray taken.
The fracture site has developed a large area of new tissue, and the fracture line has connected, but there is still a small shadow indicating that it has not completely healed.
My attending physician said that I can start walking without crutches.
I have tried walking a short distance, but I still feel a bit apprehensive because I weigh over 100 kilograms.
I would like to ask if I can walk confidently now, and whether I can start riding a motorcycle.

Xin Xian Ren, 20~29 year old female. Ask Date: 2016/07/11

Dr. Chen Yongxue reply Orthopedics

Hello, generally speaking, fractures heal within three months.
If, as mentioned in your letter, there is already a formation of callus (a large area of new tissue surrounding the fracture), it is time to stop relying on the crutches.
Prolonged dependence on crutches can lead to decreased muscle strength or muscle atrophy, which is not a good sign.
Thank you.

Reply Date: 2016/07/11

More Info

It's great to hear about your recovery progress after your femur fracture. Based on the information you've provided, it seems that you are at a critical stage in your rehabilitation journey. Here’s a comprehensive response to your questions regarding walking and resuming activities after your femur fracture.

Trusting Your Recovery
1. Walking Without Crutches: Since your doctor has advised you that you can start walking without crutches, it indicates that your fracture is healing well. The presence of new bone tissue around the fracture site is a positive sign. However, it’s important to remember that while the bone may appear to be healing, it might still be in a vulnerable state. The small shadow you mentioned could indicate that the healing process is not yet complete, which is common. It’s essential to listen to your body; if you feel pain while walking, it’s advisable to take it slow and gradually increase your activity level.

2. Weight Considerations: Given your weight of over 100 kilograms, it’s crucial to be cautious. Excess weight can put additional stress on your healing bone. Start with short walks on flat surfaces and gradually increase the distance as you feel more comfortable. If you experience pain or discomfort, it’s a signal to ease off and allow more time for healing.

3. Resuming Activities: As for riding a motorcycle, it’s generally recommended to wait until you feel confident in your ability to bear weight and move without pain. Riding a motorcycle requires good balance and strength in your legs, which may still be developing. It’s best to consult your doctor about when it would be safe to resume riding, as they can provide personalized advice based on your recovery progress.

Additional Considerations
- Physical Therapy: If you haven’t already, consider engaging in physical therapy. A physical therapist can provide you with tailored exercises to strengthen your leg muscles, improve balance, and enhance your overall mobility. They can also help you regain confidence in your movements, which is crucial after a significant injury.

- Monitoring Pain: Pain is a natural part of the recovery process, but it’s essential to differentiate between normal discomfort and pain that signals a problem. If you experience sharp or persistent pain, it’s advisable to consult your healthcare provider.

- Follow-Up Care: Continue to have regular follow-up appointments with your doctor. They may want to monitor the healing process through X-rays and assess your progress. This will help ensure that your recovery is on track and that any potential issues are addressed promptly.

- Gradual Increase in Activity: As you start walking more, aim to gradually increase your activity level. You might begin with walking short distances and then slowly add more time and distance as your confidence and strength improve. It’s also beneficial to incorporate low-impact exercises, such as swimming or cycling, which can help maintain fitness without putting too much strain on your healing bone.

Conclusion
In summary, while your doctor’s advice to start walking without crutches is a positive step in your recovery, it’s essential to proceed with caution. Pay attention to your body’s signals, consider physical therapy, and maintain regular communication with your healthcare provider. With time, patience, and proper care, you should be able to regain your strength and confidence in walking and other activities. Remember, recovery is a journey, and it’s important to take it one step at a time.

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