Delayed Healing in Femur Fractures: What You Need to Know

Femoral fracture issues?

I suffered a closed fracture of my right femur due to a car accident on May 25, and underwent surgery to insert a bone screw on May 26 (without a cast).
At my follow-up appointment on July 13, one and a half months later, the doctor indicated that the bone was healing at a normal rate.
I was using crutches with partial weight-bearing on my affected leg.
However, during my next follow-up on August 10, the doctor noted that while the bone was still healing, it was progressing more slowly than expected.
As a result, I was still limited to partial weight-bearing with crutches, and I would need to wait until my next appointment on September 7 (over three months post-surgery) for further evaluation.
I would like to know if my X-rays truly indicate that my bone is healing more slowly.
I initially thought I would be able to stop using crutches after three months, but now I can't even use a single crutch.
Since I had surgery at a different facility and have switched doctors, I am concerned about the current doctor's attitude.
I am considering whether I should change doctors next month or visit another hospital soon.
Additionally, if my bone is indeed healing slowly, could this indicate a problem with bone growth that requires supplementation? I am really worried and hope to walk again soon.
I see peers my age who were able to use a single crutch after two months and were completely off crutches by three months, while I am still struggling at two and a half months.
Thank you for your help!

Pin, 20~29 year old female. Ask Date: 2017/08/16

Dr. Shi Guozheng reply Orthopedics

Your femoral fracture has some fragments, and fractures like this typically heal more slowly.
The X-ray from the surgery looks quite good, but it will take time to heal.
Generally, fractures like this heal within six months, which is considered fast.
If it hasn't healed after a year, then we would consider bone grafting.

Reply Date: 2017/08/16

More Info

Understanding delayed healing in femur fractures can be a source of concern for many patients, especially after experiencing a traumatic event like a car accident. In your case, you sustained a closed femur fracture on May 25 and underwent surgery the following day, where bone nails were inserted to stabilize the fracture. The healing process for bone fractures can vary significantly from person to person, influenced by multiple factors including age, overall health, the type of fracture, and the quality of post-operative care.

From your description, it seems that during your follow-up appointments, the doctor noted that your bone is healing, but at a slower rate than expected. This can be frustrating, especially when you see peers recovering more quickly. However, it’s important to understand that bone healing is a complex biological process. Typically, the healing of a femur fracture can take anywhere from 3 to 6 months, depending on the individual circumstances.

The X-ray results you provided indicate that there is some bone growth, which is a positive sign. However, if the doctor has expressed concern about the speed of your healing, it may be worth investigating further. Factors that can contribute to delayed healing include:
1. Age: Older adults often experience slower healing due to decreased bone density and slower cellular regeneration.

2. Nutrition: Adequate intake of calcium, vitamin D, and protein is crucial for bone healing. If your diet lacks these nutrients, it could impede your recovery.

3. Blood Supply: The femur has a rich blood supply, but if there are any complications with blood flow due to the injury or surgical procedure, healing may be affected.

4. Smoking and Alcohol: Both can negatively impact bone healing. If you smoke or consume alcohol, consider reducing or eliminating these habits.

5. Underlying Health Conditions: Conditions such as diabetes, osteoporosis, or hormonal imbalances can also slow down the healing process.

If you are concerned about the pace of your recovery, it is reasonable to seek a second opinion. A different orthopedic specialist may provide new insights or alternative treatment options. Additionally, if you feel that your current doctor is not addressing your concerns adequately, it is within your rights as a patient to seek care elsewhere.

Regarding your worry about "non-union" or "delayed union" of the fracture, these terms refer to situations where the bone fails to heal properly. If your doctor suspects this, they may recommend further imaging studies, such as a CT scan or MRI, to assess the healing progress more accurately. In some cases, additional treatments such as bone stimulators or even surgical intervention may be necessary to promote healing.

In the meantime, ensure you are following your doctor's advice regarding weight-bearing activities. Using crutches or a walker as advised is crucial to avoid putting undue stress on the healing bone. Engage in gentle range-of-motion exercises as permitted, and maintain a healthy diet to support your recovery.

Lastly, it is essential to maintain open communication with your healthcare provider. If you have specific concerns or questions about your healing process, don’t hesitate to bring them up during your next appointment. Your health and peace of mind are paramount, and understanding your recovery process can help alleviate some of the anxiety you may be feeling.

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