Addressing Complications After Pelvic Fracture Surgery: A Patient's Dilemma

Bone screw issues

Hello doctor, my dad fell off his bicycle and fractured his pelvis along with the thigh bone, which resulted in his inability to stand.
He underwent surgery where steel pins were used.
After three months post-surgery, we visited the doctor, who mentioned that we had started putting weight on the leg too early, causing the steel pins to be inserted deeper into the pelvis.
The doctor then prescribed only pain medication.
Now, my dad experiences shaking in his standing leg and significant pain, especially when getting out of bed.
What should we do about this? Thank you, doctor.

Che, 30~39 year old female. Ask Date: 2018/04/08

Dr. Li Yongheng reply Orthopedics

Hello, based on your father's condition, he appears to have an intertrochanteric fracture of the femur at the hip joint, and it has been three months since his surgery.
The doctor mentioned that your father engaged in activities on the ground too soon, which caused the steel pin to move further into the pelvis, indicating a displacement of the bone screw.
As long as the fracture heals properly (which typically takes about six months) and the screw does not protrude through the femoral head, there is a chance he may be able to walk independently in the future without significant pain.
However, if the fracture does not heal or if the screw protrudes through the femoral head, another surgery will be necessary.
Wishing your father a speedy recovery.

Reply Date: 2018/04/08

More Info

Addressing complications after pelvic fracture surgery can be quite challenging, especially when a patient experiences pain and instability while attempting to stand. In your father's case, it sounds like he has undergone a significant injury and subsequent surgical intervention, which can lead to various complications, including improper healing, hardware issues, and pain management challenges.

Firstly, it is essential to understand that pelvic fractures can be complex injuries, often involving multiple bones and soft tissues. The use of hardware, such as steel pins, is common to stabilize the fracture and allow for proper healing. However, if the hardware becomes displaced or if there is excessive movement at the fracture site, it can lead to complications such as pain, instability, and even further injury.

In your father's situation, the fact that the doctor mentioned the steel pins have moved deeper into the pelvis suggests that there may be an issue with the fixation or the healing process. This can happen if the patient puts weight on the affected limb too soon, which can compromise the surgical repair. The shaking and pain your father experiences when standing could be attributed to several factors:
1. Muscle Weakness: After a significant injury and surgery, the muscles around the pelvis and legs may weaken due to disuse. This weakness can lead to instability and difficulty in standing.

2. Nerve Involvement: Depending on the nature of the fracture, there may be nerve involvement that can cause pain and instability. If nerves were compressed or damaged during the injury or surgery, this could lead to symptoms like shaking or pain.

3. Hardware Issues: If the steel pins have shifted, they may be causing irritation to surrounding tissues or may not be providing the necessary support for the healing bone. This could lead to increased pain and instability.

4. Pain Management: If your father is only prescribed pain medication without a comprehensive pain management plan, he may not be adequately managing his discomfort, which can affect his ability to participate in rehabilitation and regain strength.

Given these factors, here are some recommendations for addressing your father's situation:
- Follow-Up with the Surgeon: It is crucial to have a follow-up appointment with the orthopedic surgeon who performed the surgery. They can assess the position of the hardware through imaging studies (like X-rays) and determine if any further intervention is necessary.

- Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a rehabilitation program tailored to your father's needs, focusing on strengthening the muscles around the pelvis, improving balance, and gradually increasing weight-bearing activities.

- Pain Management: Discuss with the doctor the possibility of a more comprehensive pain management plan. This may include adjusting medications, introducing physical modalities (like heat or ice), or exploring alternative pain management strategies.

- Gradual Weight Bearing: If the doctor approves, your father should gradually increase weight-bearing activities under supervision. This can help improve muscle strength and stability over time.

- Assistive Devices: Depending on the level of pain and instability, using assistive devices such as a walker or crutches may provide additional support and confidence while standing and walking.

- Monitoring for Complications: Keep an eye out for any signs of complications, such as increased pain, swelling, or changes in mobility. If these occur, seek medical attention promptly.

In conclusion, addressing complications after pelvic fracture surgery requires a multidisciplinary approach involving orthopedic care, physical therapy, and effective pain management. It is essential to communicate openly with healthcare providers about your father's symptoms and concerns to ensure he receives the appropriate care and support for his recovery.

Similar Q&A

Dealing with Complications After Pelvic Fracture Surgery

Hello doctor, I previously fell while riding a bicycle, which resulted in a fracture of my pelvis and femur. I underwent surgery to have metal screws inserted. Three months post-surgery, I visited the doctor, who said I had resumed weight-bearing activities too early, causing the...

Dr. Wang Shouji reply Orthopedics
Hello: We need to assess whether your X-ray shows any impact on healing or the hip joint. If there is no impact, you can wait for healing, and the pain will gradually decrease. If there is an impact, further surgery may be necessary.

Understanding Pelvic Fractures: Surgical Options and Recovery Insights

Hello, doctor. I would like to ask about my sister. She was in a car accident and has a fracture in her pelvis and a broken small bone in her lower leg (which has been casted). However, she needs surgery for the pelvis. She also has an injury to her pancreas, and we are waiting f...

Dr. Shi Guozheng reply Orthopedics
The question you raised is difficult to answer without an X-ray for reference and without knowing which bone is fractured. If it is a simple fracture, the surgery is relatively straightforward. However, if it is a complex fracture or one near the hip joint, it becomes more challe...

Understanding Complex Pelvic Fractures and Their Treatment Options

Dear Doctor, My husband is the patient who was involved in a car accident on January 28, 2022. The medical summary indicates that he sustained a comminuted fracture of the right acetabulum with mild displacement, as well as contusions and lacerations to the forehead, and a concu...

Dr. Wang Jiacheng reply Orthopedics
After a hip joint fracture, there is a possibility of developing arthritis many years later, which requires ongoing monitoring. As for bladder issues, it may be necessary to consult a urologist.

Can Pelvic Fractures Be Repaired? A Case Study of Recovery Options

My sister was in a car accident, and her pelvis was run over by a garbage truck. The doctor diagnosed her with a shattered pelvis, and the section near the femur is almost completely broken. There is significant bleeding from the nerves, and she has already undergone surgery to c...

Dr. Zhou Lizhi reply Orthopedics
Pelvic fractures are a serious major trauma, and their impact extends beyond the pelvic bones themselves to include issues related to nerves, blood vessels, the reproductive system, and the presence of open wounds. Therefore, each patient's condition is different. If there i...