Femoral and tibial fractures?
Hello Dr.
Chen, I was involved in a car accident at the beginning of August, resulting in multiple fractures on the left side.
The more severe injuries include fractures of the left femur, tibia, and fibula (I have used a self-paid plate for fixation).
The less severe injuries include a fracture of the fifth metacarpal of the left hand and a fracture of the left pelvic pubic ramus (the left hand was only stabilized with a splint, which has now been removed).
X-ray images before and after femur surgery:
Before: https://ibb.co/d4NkCKK
After: https://ibb.co/Hh6jbPt
Before tibia and fibula surgery: https://ibb.co/dPzg29H
After tibia and fibula surgery: https://ibb.co/zrgtcry
I would like to ask:
1.
The diagnosis report indicates a fracture of the left pelvic pubic ramus but does not include specific medical advice.
Q: Does this mean it does not require treatment and will heal naturally? Will there be any long-term effects?
2.
During a follow-up appointment in early September, the doctor mentioned that the femur is healing, but there is no significant progress in the lower leg.
Q: Given that all the bones in my left leg are fractured, is it possible to walk on it in three months?
3.
Recently, I have tried to go to the bathroom at home (not putting weight on the left foot, using my right foot and a chair for support, covering a distance of about 2 meters).
Q: Is this type of movement beneficial for bone growth, or could it hinder the healing process?
Thank you very much for taking the time to respond.
Xintong, 30~39 year old female. Ask Date: 2022/09/17
Dr. Chen Bochen reply Orthopedics
1.
The diagnosis indicates a fracture of the left pelvic pubic ramus, but there are no specific medical instructions.
Q: Does this mean it can heal naturally without intervention? Will there be any long-term effects? If the pubic ramus is not significantly displaced, it can generally heal naturally.
2.
During a follow-up appointment in early September, the doctor mentioned that the femur is healing, but there has been no significant progress in the tibia.
Q: Given that there are fractures in the bones of the left leg, is it possible to walk on it in three months? If healing goes well, typically one can bear over 50% of weight in about two months, but this should be assessed by the surgeon based on follow-up X-rays.
3.
Recently, I have tried to go to the bathroom by myself at home (not putting weight on the left foot, using the right foot and a chair for support, covering a distance of about 2 meters).
Q: Is this type of movement beneficial for bone growth, or could it hinder it? Moderate activity can help promote bone growth.
Reply Date: 2022/09/17
More Info
Hello! Thank you for sharing your situation regarding your recovery from multiple leg fractures following your accident. It’s understandable to have many questions during this challenging time. Let’s address your inquiries one by one.
1. Regarding the Left Pelvic Pubic Ramus Fracture: Typically, fractures of the pubic ramus are considered stable and often heal well without surgical intervention. They usually do not require any specific treatment beyond pain management and rest. However, it’s essential to follow up with your healthcare provider to ensure that the fracture is healing correctly. While most individuals recover without significant long-term issues, some may experience chronic pain or discomfort in the pelvic area. Regular follow-ups and imaging studies can help monitor the healing process.
2. On the Healing Progress of the Femur and Lower Leg: It’s promising to hear that your femur is healing, but it’s not uncommon for lower leg fractures, especially those involving the tibia and fibula, to take longer to show significant healing progress. The timeline for weight-bearing activities varies significantly depending on the fracture's complexity, the type of surgical intervention, and individual healing rates. Generally, after three months, many patients may begin to bear weight on their injured leg, but this should always be guided by your orthopedic surgeon. They will assess your X-rays and clinical signs to determine when it is safe for you to start walking.
3. About Moving Without Weight Bearing: Your approach to moving around the house, using your right leg and a chair for support while keeping your left foot off the ground, is a cautious way to maintain some mobility. This type of movement can help you maintain your upper body strength and balance, which is beneficial during recovery. However, it’s crucial to avoid putting any weight on the injured leg until your doctor advises it is safe to do so. Premature weight-bearing can potentially disrupt the healing process and lead to complications, such as malunion or nonunion of the fractures.
In addition to addressing your specific questions, here are some general recommendations for your recovery:
- Physical Therapy: Once your doctor gives you the green light, engaging in physical therapy can significantly enhance your recovery. A physical therapist can guide you through exercises tailored to your condition, focusing on strengthening the muscles around your fractures and improving your range of motion.
- Nutrition: Ensure you are consuming a balanced diet rich in calcium and vitamin D, as these nutrients are vital for bone healing. Foods such as dairy products, leafy greens, and fortified foods can be beneficial.
- Follow-Up Appointments: Regular follow-ups with your orthopedic surgeon are crucial. They will monitor your healing through X-rays and adjust your treatment plan as necessary.
- Pain Management: If you experience pain, discuss it with your healthcare provider. They can recommend appropriate pain management strategies, including medications or alternative therapies.
- Mental Health: Recovery from significant injuries can be mentally taxing. Don’t hesitate to seek support from friends, family, or professionals if you’re feeling overwhelmed.
Remember, each recovery journey is unique, and it’s essential to listen to your body and follow your healthcare provider’s advice closely. Wishing you a smooth and speedy recovery!
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