Rehabilitation After Severe Leg Injury in Polio Patients: A Path to Recovery

Rehabilitation for Polio-Affected Legs After an Accident

I am a polio patient and originally had atrophy in my right lower limb.
I can walk normally and go up and down stairs, but I lack the strength to bend my right leg to support my weight independently.
At the end of March this year, I was involved in a motorcycle accident where a car struck me from the right side and dragged me along.
My helmet saved my life, but my right leg sustained severe injuries, including an open and comminuted fracture of the right thigh, soft tissue damage to the knee that resulted in three fragments, and a fracture at the ankle of my lower leg.
The surgeon inserted two steel pins from the heel to the ankle, and I personally purchased a steel plate to connect the fractured thigh bone with eleven screws from the side.
Due to some bone fragments being missing, artificial (bone) grafts were used for filling.
Ten days post-surgery, the cast was applied, and after four weeks, the section near the ankle was removed to allow for ankle joint flexion.
Three weeks later (yesterday), the entire cast was removed and replaced with a protective brace, with the flexion angle set at forty degrees.
After the cast was removed, the surgeon reviewed the X-rays and stated that rehabilitation cannot commence because the area filled with artificial bone only shows some light gray images, indicating that there is some long bone but it is still far from healing, so the thigh cannot bear weight.
The condition of the knee is indeterminate, but I can visually see that the patella seems to be positioned much lower towards the inner side of the leg.
When I tried to get out of bed while wearing the brace, the pain was unbearable.
Given that my polio-affected leg is already weak, any movement causes my lower leg to drop to the limited forty degrees, making it feel like my entire leg is about to snap.
Ultimately, I had to use my hands to lift the brace's securing strap at the ankle to get out of bed and use a walker to walk.
I would like to ask the doctor how long it might take before I can start rehabilitation in my situation? Is there a chance that I can return to normal walking (without crutches)? Also, considering that my polio-affected leg cannot perform a normal leg lift (as it cannot support the weight of my lower leg), how can I rehabilitate?

Wu Zhu de A Zhu, 50~59 year old female. Ask Date: 2015/05/27

Dr. Lin Jingwei reply Orthopedics

Hello, since I have not seen your X-ray and have not physically examined the wound and recovery status, I cannot determine the rehabilitation timeline.
I recommend that you visit the hospital outpatient department for a personal consultation with a physician who can provide you with relevant advice.
Thank you.

Reply Date: 2015/05/27

More Info

Rehabilitation after a severe leg injury, especially in a patient with a history of polio, is a complex and nuanced process. Given your situation, where you have experienced significant trauma to your right leg, including open and comminuted fractures, it is essential to approach recovery with a structured plan that considers both your previous condition and the new injuries.

First and foremost, it is crucial to understand that the recovery timeline can vary significantly based on individual circumstances, including the extent of the injuries, the healing process, and your overall health. Since you have already undergone surgery and are currently in a protective brace, the immediate focus should be on ensuring that the fractures heal properly before engaging in any rehabilitation exercises.

Typically, after a severe leg injury, the initial phase involves immobilization to allow for bone healing. Your doctor has indicated that you cannot bear weight on your leg yet, which is a standard precaution to prevent complications such as non-union of the fractures or further injury. The use of a brace and the prescribed range of motion (in your case, 40 degrees) is designed to protect the healing structures while allowing for some movement to prevent stiffness.

Once your doctor determines that the fractures are healing adequately—usually assessed through follow-up X-rays and clinical evaluations—you may be cleared to begin rehabilitation. This process can take several weeks to months, depending on the healing progress. Rehabilitation will likely start with gentle range-of-motion exercises to maintain joint flexibility and prevent stiffness. As your strength improves and your doctor allows, you can gradually progress to weight-bearing exercises.

Given your history of polio, it is essential to work closely with a physical therapist who understands the unique challenges you face. Polio can lead to muscle weakness and atrophy, which may complicate your recovery. A tailored rehabilitation program will focus on strengthening the muscles around your knee and ankle, improving your balance, and enhancing your overall mobility.
Your therapist may incorporate exercises that target your quadriceps, hamstrings, and calf muscles, as well as functional activities to help you regain the ability to perform daily tasks. It is also important to address any compensatory movement patterns that may have developed due to your previous condition, as these can affect your recovery and overall function.

As for your concerns about regaining normal walking ability without the use of crutches, it is indeed possible, but it will require time, patience, and consistent effort in rehabilitation. The goal is to rebuild strength and coordination in your leg, which may take longer due to the initial weakness from polio and the recent injuries.
In terms of pain management, it is crucial to communicate openly with your healthcare team about any discomfort you experience during rehabilitation. Pain can be a barrier to progress, and adjustments to your therapy may be necessary to ensure you can participate fully without exacerbating your condition.

In summary, while the path to recovery after such significant injuries can be challenging, with the right medical support and a dedicated rehabilitation plan, there is a strong possibility of regaining functional mobility. It is essential to remain optimistic and committed to your rehabilitation journey, as progress may be gradual but is achievable with perseverance and the right guidance. Always consult with your healthcare providers to tailor your rehabilitation plan to your specific needs and circumstances.

Similar Q&A

Improving Mobility in Post-Polio Patients: Rehabilitation Options

Hello, my father contracted polio as an infant, resulting in atrophy and weakness in one of his legs. He seemed to have worn a metal brace for a period when he was around thirty, and at that time, he was still able to walk with the support of one leg. He is now 53 years old and h...

Dr. Li Weiqiang reply Rehabilitation
Dear Angel, Hello, my father contracted polio during infancy, resulting in atrophy and weakness in one leg. It seems that around the age of thirty, he wore a leg brace for a period, during which he was still able to walk with the support of one leg. He is now 53 years old and ha...

Post-Amputation Rehabilitation: Starting Recovery After Leg Surgery

Hello Dr. Chen: My friend had an amputation of the left lower leg due to a car accident and has completed surgery three months ago. Can he start rehabilitation now? Does your hospital offer training? What are the procedures to follow?

Dr. Chen Xianchang reply Rehabilitation
Hello, sir: Thank you for your inquiry. I would like to address your questions and provide some recommendations: 1. You may begin rehabilitation by registering at our hospital's rehabilitation department, where physical therapy will be arranged for you. 2. At home, it is imp...

Exploring the Link Between Motor Neuron Degeneration and Post-Polio Syndrome

Dear Dr. Jian, I have the following questions and would appreciate your guidance: At the age of three, I experienced atrophy and weakness in my left lower limb due to poliomyelitis and have never received rehabilitation or assistive devices. In 2005, I suddenly lost the abilit...

Dr. Jian Yingxiu reply Rare Disease
MND or ALS should be discussed with a neurologist. Currently, certain diseases can be diagnosed through genetic testing, so you may want to consult your neurologist about this. However, your previous cervical spine issues may also contribute to these symptoms, so it is essential ...

Exploring Treatment Options for Polio: Hope for Recovery and Clinical Trials

Hello, I am a polio survivor with lower limb weakness. I would like to know if there is currently a complete cure available and if there are any opportunities for clinical trials. If so, I am very willing to participate. Thank you for your response!

Dr. Zhang Junwei reply Neurosurgery
Hello: So far, there is no effective treatment for lower limb weakness caused by poliomyelitis in children!