Recovery Insights for Open and Comminuted Femur Fractures: A Patient's Journey

Open and comminuted fracture of the right femur, from July 4 to now November 16, with the fracture located in the middle of the thigh?

Hello Doctor, I had an open and comminuted fracture of my right thigh due to a car accident on July 4th.
I thought that the absence of pain meant I could walk, so I started using crutches around the end of July.
During follow-up visits, X-rays showed minimal bone growth; there was some growth, but it was very slight and not in the correct position.
I do not smoke, and my thigh was stabilized with a steel plate and one screw on top and two screws below.
On November 13th, I underwent another surgery to remove the two screws below and had bone marrow aspirated and injected at the fracture site in the middle of my thigh.
My doctor advised me to put weight on my leg while walking, but I still have not had my stitches removed, and the area where I was stitched is only slightly painful.
I would like to know if I should continue using crutches to walk, or if I should not use crutches and put more weight on my leg? Should I use one crutch or a single crutch with partial weight-bearing (50%)? I really do not feel any pain while walking.
Additionally, should I take calcium supplements, vitamin C, or other health supplements? Or should I consider traditional Chinese medicine? The doctor mentioned that it has been four months since the fracture, and after this surgery, it will be six months since the initial injury.
Typically, bones should heal within six months.
If my bone has not healed by then, will I need another surgery in two months to use my own bone for a bone graft?

Xiong, 10~19 year old female. Ask Date: 2023/11/16

Dr. You Dianqi reply Orthopedics

It is advisable to discuss your concerns with your original attending physician (surgeon), as each individual's injury severity and recovery process can vary.
Please return for a follow-up appointment to discuss your concerns with the doctor, and ask them to evaluate the subsequent rehabilitation methods or any other treatments needed.
For dietary advice and postoperative care, you may consult a nutritionist.
Thank you.

Reply Date: 2023/11/16

More Info

Recovering from an open and comminuted femur fracture, especially after a traumatic event like a car accident, can be a complex and lengthy process. Your situation involves multiple factors, including the nature of the fracture, the surgical interventions you've undergone, and your overall health and rehabilitation efforts. Let's break down your concerns and provide some insights based on medical knowledge.

Recovery Timeline and Expectations
Typically, the healing process for a femur fracture can take anywhere from 4 to 6 months, depending on various factors such as the severity of the fracture, the type of surgical fixation used, and the patient's age and overall health. In your case, since you had an open and comminuted fracture, the healing process may be more complicated. The presence of a steel plate and screws indicates that your fracture was significant enough to require surgical stabilization.

It's important to understand that while some bone growth may be visible on X-rays, complete healing can take longer, especially in cases of comminuted fractures where the bone is shattered into multiple pieces. The fact that your doctor mentioned the need for bone marrow aspiration to promote healing suggests that they are taking proactive steps to enhance your recovery.

Weight Bearing and Mobility
Regarding your question about using crutches or walking aids, it is crucial to follow your doctor's advice. If your doctor has advised you to start bearing weight on your leg, you might be able to transition from crutches to partial weight-bearing with a single crutch or even walking without assistance, depending on your comfort level and stability. However, if you feel any discomfort or instability, it is wise to continue using crutches until you feel more confident.
Using a single crutch can help you gradually increase your weight-bearing capacity while providing support. It is essential to listen to your body; if you experience pain or discomfort, it may be a sign that you need to adjust your approach.

Nutritional Support for Healing
Regarding your inquiry about supplements, calcium and vitamin D are crucial for bone health and healing. Vitamin C is also important for collagen synthesis, which is vital for bone and tissue repair. While over-the-counter supplements can be beneficial, it's best to consult with your healthcare provider before starting any new regimen, especially considering your recent surgeries and current medications.

If you are considering traditional Chinese medicine or herbal supplements, it is essential to discuss these with your doctor to avoid any potential interactions with your prescribed medications or surgical recovery.

Future Surgical Interventions
If, after 6 months, your fracture has not healed adequately, your doctor may discuss further interventions, such as bone grafting. This procedure involves using bone from another part of your body or a donor to help stimulate healing in the fractured area. The decision for additional surgery will depend on various factors, including the quality of the bone healing observed on X-rays and your overall health.

Conclusion
In summary, your recovery from an open and comminuted femur fracture will require patience and adherence to your doctor's recommendations. Continue to monitor your symptoms, maintain open communication with your healthcare team, and focus on a balanced diet to support your healing process. Remember, every patient's journey is unique, and your healthcare provider is your best resource for personalized advice and guidance throughout your recovery.

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