Recovering from a Complex Femoral Shaft Fracture: When to Ditch the Crutches?

Comminuted femoral shaft fracture due to a car accident?

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, resulting in a comminuted fracture of the femoral shaft, with the doctor stating it was broken in three places.
I then underwent a self-funded surgery costing 80,000 NTD for internal fixation with steel nails.
It has now 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 stop using crutches after about three months.
Since a few days after the surgery, I have been walking and rehabilitating with the help of a physical therapist, and my leg strength has recovered to about 70%.
The range of motion is also quite good, and I experience minimal pain.
Later, at a nearby clinic, the therapist allowed me to walk with a single crutch for balance, and my walking is now almost at a normal pace.
My question is, am I able to completely stop using crutches?

Miss Hong, 10~19 year old female. Ask Date: 2022/12/26

Dr. Shi Guozheng 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, which is the correct course of action.

Reply Date: 2022/12/26

More Info

Recovering from a complex femoral shaft fracture can be a challenging journey, and it's great to hear that you are making progress in your rehabilitation. Given your situation, it’s important to consider several factors before deciding to ditch the crutches completely.

Firstly, the timeline for recovery from a femoral shaft fracture can vary significantly from person to person. While some individuals may be able to transition off crutches within three months, others may take longer, especially if the fracture was complex or if there were complications during the healing process. In your case, since you mentioned that your doctor noted slow healing, it is crucial to follow their guidance closely.

You indicated that you have regained about 70% of your strength and that you can walk with a single crutch, which is a positive sign. However, before fully transitioning to walking without crutches, consider the following:
1. Pain and Discomfort: You mentioned that you are not experiencing much pain anymore, which is a good indicator. However, if you feel any discomfort or pain while walking, it may be wise to continue using crutches until you are pain-free.

2. Stability and Balance: Since you are able to walk with a single crutch and are close to a normal gait, assess your balance and stability. If you feel confident and stable while walking with one crutch, you might be ready to try walking without it for short distances. However, it’s advisable to keep the crutch handy in case you need it for support.

3. Physical Therapy Guidance: Your physical therapist is a key resource in this process. They can assess your strength, range of motion, and overall functional ability. If they believe you are ready to transition off crutches, they can provide a structured plan to do so safely.

4. Gradual Transition: If you decide to try walking without crutches, do so gradually. Start by walking short distances in a safe environment, such as your home, where you can easily grab a crutch if needed. Monitor how your body responds during and after these attempts.

5. Follow-Up Appointments: Continue to attend your follow-up appointments with your orthopedic surgeon. They can evaluate your healing through imaging studies and provide personalized recommendations based on your recovery progress.

6. Listen to Your Body: Ultimately, your body will give you signals about whether you are ready to ditch the crutches. If you feel fatigued, experience pain, or have difficulty maintaining balance, it may be best to continue using them until you feel stronger.

In conclusion, while you are making significant strides in your recovery, it is essential to approach the decision to stop using crutches with caution. Consult with your healthcare providers, listen to your body, and take gradual steps towards independence in walking. Remember, the goal is not just to walk without crutches but to do so safely and effectively, minimizing the risk of re-injury. Good luck with your recovery, and keep up the great work in your rehabilitation!

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