Thigh Fractures: X-ray Insights and Walking Challenges - Orthopedics

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Femoral fracture X-ray and walking issues?


The issue regarding my femur fracture is as follows: I had a closed femur fracture from a car accident on May 25 of this year.
The first X-ray taken on May 26 shows that I underwent surgery to insert a bone screw (without a cast).
In the upper right corner, the area circled in green seems to have a slight crack (the image is not very clear).
The second X-ray taken on June 15, during a follow-up visit for suture removal, shows that the bone in the lower left corner appears to have healed a bit, while the crack circled in green in the upper right corner seems to be more pronounced.
The third X-ray taken on July 13 during another follow-up visit shows that the bone in the lower left corner appears to have protruded a bit again, and the crack circled in green in the upper right corner is even more noticeable, although some areas of the crack seem to have healed.
The doctor mentioned that the bone is starting to heal at a normal rate, and I should continue using crutches but can put some weight on my foot.
My next follow-up appointment is on August 10 (11 weeks post-surgery).
Is there a chance I could switch to a single crutch? I hope to be able to walk without crutches by the end of August (the third month), as I need to return to work (which involves taking the bus and walking a short distance; my workstation is at a computer desk and does not require heavy lifting or constant walking).
Is this possible? Additionally, will the crack in the upper right corner affect the healing time of the bone? Why does the bone in the lower left corner appear to be worse than before? Is this due to the angle of the X-ray? Thank you, doctor!

A-Hsuan, 20~29 year old female. Ask Date: 2017/07/22

Dr. Li Yongheng reply Orthopedics


Hello: The fracture lines are usually not very clear on X-rays immediately after the fracture occurs.
However, 4 to 6 weeks later, the fracture lines will become more apparent, which is a normal phenomenon, so there is no need for you to worry.
If the doctor says during your follow-up visit that the bone has started to heal at a normal rate, then you may have the opportunity to fully discontinue the use of crutches by the end of August (the third month).
Therefore, you can have another X-ray taken at the end of August and ask your physician to confirm whether you can fully stop using crutches.
Wishing you a speedy recovery.

Reply Date: 2017/07/22

More Info


Understanding thigh fractures, particularly in the context of recovery and rehabilitation, is crucial for patients who have undergone surgery. In your case, you experienced a closed femoral fracture due to a car accident, which required surgical intervention involving the insertion of bone screws. The X-ray images you referenced show the progression of your healing process over time, and it’s important to interpret these images correctly to understand your recovery trajectory.

Firstly, it’s common for fractures to appear more pronounced on X-rays during the healing process. Initially, the fracture may not show significant displacement or may appear less severe, but as healing progresses, the callus formation and changes in bone density can make the fracture line more visible. This is a normal part of the healing process and does not necessarily indicate a setback. Your doctor’s assessment that the bone is healing at a normal rate is a positive sign.

Regarding your ability to transition from using crutches to a single crutch or even walking unaided, this largely depends on the stability of the fracture site and your overall pain levels. By the 11th week post-surgery, many patients are able to start bearing more weight on the affected leg, especially if they are experiencing minimal pain and the X-rays show signs of healing. However, it is essential to follow your doctor’s advice closely. They will assess your healing through physical examination and imaging studies during your next appointment on August 10th. If everything looks good, there is a reasonable chance you could transition to a single crutch or even walk without assistance by the end of August.

As for the specific concerns regarding the fracture line in the upper right corner of your X-ray, it’s important to note that while some fractures may take longer to heal, the presence of a visible fracture line does not always correlate with delayed healing. Factors such as the type of fracture, the quality of bone, and your overall health can influence healing times. Your doctor will consider these factors when evaluating your recovery.

The appearance of the lower left portion of the bone in your X-ray may indeed be influenced by the angle of the X-ray or the positioning of your leg during the imaging process. Variations in X-ray angles can sometimes create the illusion of more severe damage or changes in bone structure. It’s essential to have a qualified radiologist interpret these images in conjunction with your clinical findings.

In terms of your overall recovery, it’s crucial to engage in rehabilitation exercises as recommended by your healthcare provider. These exercises will help restore strength and mobility to your leg, which is vital for a successful return to daily activities and work. Nutrition also plays a significant role in bone healing; ensure you are consuming adequate amounts of calcium and vitamin D, which are essential for bone health.

In summary, while you may have concerns about your healing process and the implications of your X-ray findings, the best course of action is to maintain open communication with your healthcare team. They will provide you with the most accurate assessments and recommendations based on your specific situation. With proper care and adherence to rehabilitation protocols, you should be on track for a successful recovery.

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