Recovering from Femoral Shaft Fracture: When Can You Walk Without Crutches?

Femoral shaft comminuted fracture?

Hello, this is my first time using this, and I'm not sure how to upload photos.
I had a car accident on August 26 and suffered a comminuted fracture of the femoral shaft.
The doctor said it was broken in three pieces.
I then underwent a self-funded internal fixation surgery with steel nails costing 80,000 NTD.
It has been almost four months since the surgery.
During my follow-up visits, the doctor mentioned that my healing is progressing slowly, but I see that most people can discard crutches after about three months.
Since a few days after the surgery, I have been walking and rehabilitating with the physical therapist, and my leg strength has recovered to about 70%.
The range of motion is also quite good, and I don't experience much pain anymore.
Later, at a nearby clinic, I was allowed to walk with a single crutch for balance, and my walking is almost at a normal pace.
My question is, am I able to completely discard the crutch now?

Miss Hong, 10~19 year old female. Ask Date: 2022/12/23

Dr. Wang Jiacheng reply Orthopedics

Typically, if the images on the X-ray show that the fracture has healed, the use of crutches may no longer be necessary.
However, if the bone has not healed properly, caution is required, as there is a possibility of re-fracture.
Therefore, it is essential to return for a follow-up appointment for the physician to evaluate the condition.

Reply Date: 2022/12/23

More Info

Recovering from a femoral shaft fracture can be a complex process, especially when the injury is severe, as in your case with a comminuted fracture. It's great to hear that you are making progress in your rehabilitation, and I appreciate your detailed description of your recovery journey.
In general, the timeline for returning to normal walking without crutches after a femoral shaft fracture can vary significantly based on several factors, including the severity of the fracture, the surgical intervention, and individual healing rates. Typically, most patients can begin to transition away from crutches around 8 to 12 weeks post-surgery, provided that they have adequate strength, balance, and pain control. However, since you mentioned that your doctor indicated your healing has been slow, it’s essential to approach this transition cautiously.

Given that you are now nearly four months post-surgery and have regained about 70% of your strength, it sounds like you are on the right track. The fact that you can walk with a single crutch and maintain a near-normal gait is a positive sign. However, before fully abandoning the crutch, consider the following points:
1. Consult Your Doctor: Always follow your orthopedic surgeon's advice regarding weight-bearing activities. They will assess your X-rays and clinical signs to determine if your bone has healed sufficiently to support full weight without crutches.

2. Pain and Swelling: If you experience pain or swelling when walking, it may indicate that your body is not yet ready for full weight-bearing. Pay attention to how your body responds during and after activity.

3. Balance and Stability: Ensure that you feel stable and balanced when walking without crutches. If you find yourself struggling to maintain balance, it may be wise to continue using the crutch until you feel more confident.

4. Physical Therapy: Continue working with your physical therapist. They can provide exercises to improve strength, flexibility, and balance, which are crucial for a safe transition to walking without crutches.

5. Gradual Transition: If you decide to try walking without crutches, do so gradually. Start by walking short distances and use the crutch as needed for support. This approach allows you to gauge your strength and stability without risking a fall.

6. Follow-Up Imaging: Since your healing has been described as slow, it might be beneficial to have follow-up imaging (like an X-ray) to confirm that the fracture is healing properly before making any significant changes to your mobility aids.

In summary, while you are making excellent progress, the decision to fully abandon crutches should be made in consultation with your healthcare provider. They will consider your specific circumstances, including the nature of your fracture and your overall recovery progress. Remember, the goal is not just to walk without crutches but to do so safely and effectively, minimizing the risk of re-injury. Keep up the good work with your rehabilitation, and best wishes for a continued smooth recovery!

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