Symptoms After Leg Rod Surgery: What to Expect

Symptoms after leg intramedullary nailing?

I experienced the greatest setback of my life when I was involved in a serious car accident.
I was close to losing my life, but thankfully I survived.
However, I suffered a fracture in my thigh bone and my knee bone was also bent.
The doctor inserted a long rod into my thigh, close to the knee, and secured it with four screws.
It has been over three months since my accident in June.
I started walking after two months of diligent rehabilitation, and now I can walk freely without any aids, and I don't feel any pain in my leg.
However, I have a problem: I feel that the screws in my knee area are becoming increasingly tight and uncomfortable.
Walking feels tighter than before, and even while sitting, I feel extremely tight.
Sleeping is even worse; I wake up suddenly with pain, even when my leg is straight.
I would like to ask how long it typically takes for the bones to heal sufficiently for the screws to be removed.
Is it possible to have them removed in six months? I really don't want to endure discomfort from the screws for a year before they can be taken out.
By the way, I can already touch my calf to my thigh when bending my knee, but I haven't had the courage to sit down because of the discomfort caused by the rod in my thigh.

Thank you for your response.
I wish you all the best and good health.

Xiao Hui, 40~49 year old female. Ask Date: 2010/09/09

Dr. Zhou Lizhi reply Orthopedics

First of all, congratulations on your good recovery.
The femur and patella are actually two different bones.
The femur is typically stabilized using a steel rod and four screws.
If the fracture heals well, there are usually no symptoms, except that the exposed bone screws may slightly irritate when the leg is bent excessively.
Since the femur bears weight, it is recommended to remove the hardware after one year.
The patella, being a small bone located at the joint, may cause discomfort due to the presence of the screws, especially when bending the knee.
The decision to remove the screws after six months to a year depends on the healing status of the bone, which can be assessed through follow-up X-rays in the outpatient clinic.
Otherwise, removing the screws prematurely could result in a re-fracture, which would be counterproductive.

Reply Date: 2010/09/09

More Info

After undergoing leg rod surgery, particularly following a severe accident that resulted in significant injuries, it is common to experience a range of symptoms and discomforts as you recover. Your situation, where you had a long rod inserted into your thigh and multiple screws for stabilization, is not uncommon in orthopedic trauma cases. Here’s a comprehensive overview of what you might expect during your recovery and some insights into your concerns.

Understanding Post-Surgical Symptoms
1. Tightness and Discomfort: It is not unusual to feel tightness around the area where the rods and screws are placed. This sensation can be attributed to several factors:
- Healing Process: As your bones heal, the surrounding tissues, including muscles and ligaments, may also tighten as they adapt to the new structural support provided by the hardware.

- Scar Tissue Formation: After surgery, scar tissue can develop around the surgical site, leading to a feeling of tightness or discomfort. This is a normal part of the healing process but can sometimes cause sensations that feel restrictive.

2. Pain and Sensitivity: The discomfort you experience, especially when waking up or after prolonged periods of inactivity, may be due to:
- Nerve Sensitivity: The surgical procedure may have affected nearby nerves, leading to heightened sensitivity or pain in the area.

- Muscle Atrophy: If you were immobilized for a period, the muscles around your knee may have weakened, contributing to discomfort when you move or put weight on your leg.

3. Range of Motion: It’s encouraging to hear that you can bend your knee to the point where your calf touches your thigh. This indicates good progress in your rehabilitation. However, the fear of discomfort when sitting or moving is understandable, especially with the presence of hardware.

Timeline for Hardware Removal
Regarding your question about the timeline for removing the rods and screws:
- Typical Duration: Generally, orthopedic surgeons recommend waiting at least 6 to 12 months post-surgery before considering hardware removal. This timeframe allows for adequate bone healing and ensures that the hardware is no longer necessary for stability.

- Factors Influencing Removal: The decision to remove the hardware depends on several factors, including:
- Bone Healing: X-rays or other imaging studies will help determine if the bone has healed sufficiently.

- Symptoms: If the discomfort from the hardware significantly impacts your quality of life, your surgeon may consider removal sooner.

- Surgeon’s Assessment: Regular follow-ups with your orthopedic surgeon are crucial. They will evaluate your healing progress and discuss the best course of action based on your symptoms and recovery.

Recommendations for Managing Discomfort
1. Physical Therapy: Continue with your rehabilitation exercises. A physical therapist can provide tailored exercises to strengthen the muscles around your knee and improve flexibility, which may alleviate some of the tightness you feel.

2. Pain Management: Discuss any persistent pain with your doctor. They may recommend pain management strategies, including medications or alternative therapies.

3. Follow-Up Appointments: Keep up with your follow-up appointments. Regular assessments will help your surgeon monitor your healing and make informed decisions about hardware removal.

4. Listen to Your Body: While pushing through discomfort is part of recovery, it’s essential to listen to your body. If certain movements cause significant pain, it’s crucial to address these with your healthcare provider.

Conclusion
Recovering from leg rod surgery is a gradual process, and it’s great to hear that you’re making progress. The tightness and discomfort you’re experiencing are common, but they should be monitored closely. Regular communication with your orthopedic surgeon and physical therapist will be vital in ensuring a smooth recovery and addressing any concerns about the hardware. Remember, your health and comfort are paramount, and it’s okay to seek adjustments in your treatment plan as needed. Wishing you a continued recovery and improved comfort in the coming months!

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