Pain After Femoral Shaft Fracture Surgery: Is It Normal?

Q: Pain After Femoral Shaft Fracture Surgery: Is It Normal?

Hello, Xiaoyu： It is recommended to visit the hospital outpatient department for another X-ray to confirm the actual condition! Dr. <br>Su Yiren, Orthopedics, Puzi Hospital.

Right femoral shaft fracture?

I have a right femoral shaft fracture (the break is lower, close to the knee area, and the knee itself is not injured).
I underwent open reduction and internal fixation surgery about two months ago.
Shortly after, a physician at another hospital removed one of the internal screws, stating that it was to allow my leg to bear weight, but I am unsure which one was removed.
Originally, there were three screws, so now only two remain.
The doctor advised me that I could start using a single crutch, but now my leg can bend fully, yet I experience severe pain whenever I apply even slight pressure on my right leg (the pain seems to be around the knee area, not at the fracture site).
In the first one to two weeks of using the single crutch, I did not experience this issue, which is now causing me concern.
Dr.
Su, is this a normal situation? I would appreciate your guidance.
Thank you.

Xiao Yu, 20~29 year old female. Ask Date: 2003/08/23

Dr. Su Yiren reply Orthopedics

Hello, Xiaoyu: It is recommended to visit the hospital outpatient department for another X-ray to confirm the actual condition! Dr.
Su Yiren, Orthopedics, Puzi Hospital.

Reply Date: 2003/08/23

More Info

Experiencing pain after surgery, particularly following a femoral shaft fracture, is a common concern among patients. In your case, having undergone an open reduction and internal fixation surgery two months ago, it is understandable to have questions regarding the pain you are experiencing, especially since it seems to be localized around the knee rather than at the fracture site itself.

Firstly, it is important to recognize that post-operative pain can be influenced by several factors, including the extent of the surgery, the healing process, and the physical therapy regimen. After a significant surgical intervention like yours, it is not unusual to experience pain as the body heals. The pain you describe, particularly when weight-bearing or using a single crutch, could be attributed to several reasons:
1. Healing Process: The body goes through various stages of healing after a fracture and surgery. Initially, there may be inflammation and swelling, which can contribute to pain. As the bone begins to heal, the surrounding muscles and soft tissues may also need time to adjust and strengthen, which can lead to discomfort.

2. Muscle Weakness and Imbalance: After a period of immobilization or limited use of the leg, the muscles around the knee and hip may weaken. This weakness can lead to instability and pain when you begin to put weight on the leg. It is essential to engage in physical therapy to strengthen these muscles gradually.

3. Nerve Sensitivity: Surgery can sometimes irritate or damage nearby nerves, leading to sensations of pain or discomfort that may not be directly related to the surgical site. This could explain the pain you feel around the knee rather than at the fracture site.

4. Biomechanical Changes: Adjusting to using a single crutch may alter your gait, which can place additional stress on the knee joint. This change in biomechanics can lead to pain as your body adapts to the new movement patterns.

5. Potential Complications: While less common, it is essential to rule out complications such as hardware issues (e.g., the remaining internal pins) or other orthopedic concerns. If the pain is severe or worsening, it would be prudent to consult your orthopedic surgeon for an evaluation, which may include imaging studies to assess the alignment and integrity of the healing bone.

In summary, while some pain is expected after such a procedure, the specific nature and location of your pain warrant attention. It is advisable to monitor the pain closely and communicate any changes to your healthcare provider. They may recommend modifications to your rehabilitation program, additional imaging, or other interventions to ensure optimal recovery. Engaging in a structured physical therapy program can be beneficial in addressing muscle weakness and improving function, ultimately helping to alleviate pain as you progress in your recovery.

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