Comminuted femoral fracture
Hello Doctor: I was involved in a car accident on January 25 of this year, resulting in a comminuted fracture of my right femur.
The following day, I underwent surgery (open reduction and internal fixation with nails and plates).
It has now been four months post-surgery, and during my recent follow-up, the doctor informed me that the fracture has not yet healed, and I need to continue using a single axillary crutch for ambulation.
I have a few questions for you:
Q1: About a month ago (three months post-surgery), I went to a rehabilitation clinic for physical therapy, which included electrical stimulation, heat therapy, extracorporeal shockwave therapy, and manual therapy.
The physical therapist advised that I could stop using the crutch, so I have been walking without it for the past month.
I would like to know if stopping the use of the crutch too early could affect bone healing.
What criteria should be used to determine the appropriate time to discontinue crutch use for ambulation?
Q2: I have been experiencing occasional sharp pain on the side of my right thigh.
Is this normal?
Q3: Does diet have an impact on bone healing? What should I eat to help promote bone healing?
Thank you, Doctor, for taking the time to respond.
Miss Yang, 20~29 year old female. Ask Date: 2023/05/25
Dr. Shi Guozheng reply Orthopedics
1.
Weight-bearing walking should only be done after healing.
Walking with crutches too early may lead to a re-fracture.
2.
Normal.
3.
A nutritious diet is essential, and it is important to supplement with calcium, protein, vitamins, and other nutrients.
Reply Date: 2023/05/25
More Info
Hello! It sounds like you’ve been through a very challenging experience with your femoral fracture and subsequent recovery. Let’s address your questions one by one, while also providing some additional insights into the healing process of femoral fractures.
Q1: Early Discontinuation of Crutches and Its Impact on Healing
Discontinuing the use of crutches before your doctor has advised you to do so can potentially impact the healing of your fracture. The primary concern is that putting weight on a healing bone too soon can lead to complications such as delayed union or non-union, where the bone fails to heal properly. The correct time to stop using crutches is typically determined by several factors, including:
1. X-ray Findings: Regular follow-up X-rays are crucial to assess the healing progress. If the X-rays show signs of healing, your doctor may advise you to gradually reduce the use of crutches.
2. Pain Levels: If you experience significant pain while walking, it may indicate that the bone is not ready to bear weight.
3. Functional Ability: Your ability to perform movements without pain and with stability is also a key indicator.
It’s essential to follow your orthopedic surgeon’s advice regarding weight-bearing activities. If you have already stopped using crutches, monitor your pain levels and any swelling closely, and consult your doctor if you have concerns.
Q2: Experiencing Pain in the Thigh Area
Experiencing pain, particularly sharp or "shooting" pains in the thigh area after a femoral fracture is not uncommon. This could be attributed to several factors:
1. Nerve Regeneration: After surgery, nerves may take time to heal, and you might experience sensations as they recover.
2. Muscle Strain: As you begin to use your leg more, the surrounding muscles may be compensating for the injury, leading to soreness or cramping.
3. Scar Tissue: The formation of scar tissue around the surgical site can also contribute to discomfort.
However, if the pain is severe or worsening, it’s important to discuss this with your healthcare provider to rule out any complications.
Q3: Nutrition and Bone Healing
Nutrition plays a significant role in the healing process of bones. Certain nutrients are particularly important for bone health:
1. Calcium: Essential for bone formation. Dairy products, leafy greens, and fortified foods are good sources.
2. Vitamin D: Helps the body absorb calcium. Sunlight exposure, fatty fish, and fortified foods can help maintain adequate levels.
3. Protein: Important for tissue repair and overall recovery. Include lean meats, fish, eggs, beans, and legumes in your diet.
4. Magnesium and Zinc: These minerals also support bone health and can be found in nuts, seeds, whole grains, and legumes.
5. Hydration: Staying well-hydrated is crucial for overall health and can aid in recovery.
Avoid excessive alcohol and smoking, as these can negatively impact bone healing.
Additional Recovery Tips
- Physical Therapy: Continue with your physical therapy as advised. It can help improve strength, flexibility, and range of motion in your leg.
- Gradual Weight Bearing: If your doctor approves, gradually increase the weight you place on your leg. Start with partial weight-bearing and progress as tolerated.
- Listen to Your Body: Pay attention to your body’s signals. If you experience pain or discomfort, it may be a sign to slow down.
- Follow-Up Appointments: Keep all follow-up appointments with your orthopedic surgeon to monitor your healing progress.
In conclusion, recovery from a femoral fracture can be a lengthy process, and it’s essential to adhere to your healthcare provider's recommendations. If you have any concerns about your healing or recovery, don’t hesitate to reach out to your doctor for personalized advice. Wishing you a smooth and speedy recovery!
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