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Thread: femur fracture

  1. #1
    Senior Member iskumbro's Avatar
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    femur fracture

    I fractured my femur and my right leg is swollen right now. I was doing internal rotation stretchings until it just snapped. this was yesterday. Does this need surgery. I saw from the x-ray that the bone was diagonally fractured.

    I have no sensation with my right leg and I have been taking mefenamic for pain and celebrex for anti-inflammation.

    Any advise for fast healing.

    the leg droops when I am seated down. I think time is of the essence and I will see an orthoto doctor and ask what is the best to do. It just snapped with me feeling no pain and now swelling has not subsided.

    Any suggestions will be a big help
    He ai'nt heavy, he is my brother!
    Rufus Wainright

    ronaldlora.blogspot.com

  2. #2
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    Fractured Femur

    If your femur is fractured, you should have an orthopedic doctor look at it at soonest. You may not necessarily need surgery. My daughter broke her femur last year. At first they put a straight brace on it, but it was very difficult to get around and in and out of the car, we had to rent a hospital wheelchair with the footrest out straight. Once the swelling went down she was able to have a brace with a hinge at the knee and a special long sock to protect her skin. Slowly got it to a 45 degree angle so she could sit in her own wheelchair. You do not want a plaster cast because if you get any skin irritation or pressure sores, you won't be able to feel them or see them under the cast. The femur has to be imobilized to heal. Ice for the swelling. It took over 6 months to completely heal it's a huge pain and inconvenient, be patient.

  3. #3
    Senior Member iskumbro's Avatar
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    the swelling looks bad after two days. The orthopedic doctor suggested putting metal plates.

    Jenny'smom, did the bones attach itself again in the case of your daughter?
    He ai'nt heavy, he is my brother!
    Rufus Wainright

    ronaldlora.blogspot.com

  4. #4
    I had the exact same thing happen. A spiral fracture of my left femur during range of motion exercise. I'll never forget hearing the gut-wrenching "CRACK!" but there was no pain at all.

    Anyway, in my case they opted for a rod. On the plus side it means the break is immediately stabilized and you don't need a cast or brace. Downside is you have even more metal in your body!

    Either way, one thing you'll want to watch out for is heterotopic ossification. I already had some in my left hip but the break really increased the progression of bone growth. If you get the rod then you can resume range of motion in your leg right away, which is your best defense against HO. You really don't want to let HO set in if you can help it.

  5. #5
    Quote Originally Posted by Lazlo View Post
    I had the exact same thing happen. A spiral fracture of my left femur during range of motion exercise. I'll never forget hearing the gut-wrenching "CRACK!" but there was no pain at all.

    Anyway, in my case they opted for a rod. On the plus side it means the break is immediately stabilized and you don't need a cast or brace. Downside is you have even more metal in your body!
    My situation was very similar to Lazlo's. During physical therapy I stretched to "vigorously" and snapped my left distal femur. The OS said my knee was too tight so he put a 13.5" plate on my leg. I had about a 15" incision and 45 staples and was a really impressive sight. At four weeks, a very faint xray where the break was and at nine weeks, there was no sign of fracture. I still use my left leg a little transferring but after leaving the hospital I experienced very little pain and no problems since.

    Good luck with your choice.
    Millard
    ''Life's tough... it's even tougher if you're stupid!'' -- John Wayne


  6. #6
    I had a bad spiral fracture that I got turning over in bed. My foot caught in the covers and did not turn with me. They clamped, screwed, and wired 17 pieces together and I had some problems when the hardware started coming loose. Eventually it healed with HO, which is typical for SCIs with that kind of fixation.

    I fell out of my chair and fractured it a second time right below where it healed. My doc said "enough of this" and he put in a rod the whole length of my femur. I was up and around in a couple days and it healed with minimal HO at the fracture site. With the rod, it will not likely break again. I strongly urge you to go for a rod if at all possible. Many docs tend to shrug off fractures since we do not walk. However, I know several SCIs who ended up with healing that messed up their transfers or other function. Besides, crooked legs look weird, and healing takes longer, and the pain lasts longer. If I break the other one, I will insist on a rod, if possible.
    You will find a guide to preserving shoulder function @
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  7. #7

    For those of us who are abbreviation challenged

    When I broke my tibia/fibia (two spiral fractures), I wore a stabilizing boot. The orthopedic trauma surgeon would not put in pins, plates, rods, or staples because of my level of osteoporosis. He said that non of the hardware available to him would anchor in my very thin bones. The fractures healed without incident. I spent a lot of time with my foot elevated to relieve swelling.

    I did not know what HO was. I searched on this site and found that HO stands for Heterotopic Ossification. A brief description follows:
    http://www.wisegeek.com/what-is-hete...sification.htm
    Heterotopic ossification refers to the growth of bone material in the soft tissues of the body, including muscles, tendons, and fascia. The severity of the conditions varies; some patients only have small nodules of excess bone which are noted on x-rays, while others suffer severe and debilitating pain. The cause of heterotopic ossification is not fully understood, and the most effective treatment for the condition is aggressive surgery, although some doctors have had success with radiation.

    ”Heterotopic” essentially means “wrong place,” while “ossification” refers to bone formation. Originally, heterotopic ossification was grouped under the heading “myositis ossificans,” along with an assortment of similar conditions. This term is no longer widely used in reference to heterotopic ossification, since the problem is not confined to the muscles. A related condition, ossifying fibromyopathy, usually confines itself to the fibrous tissue of the body, while periarticular ossification can be found in the region around the joints.

    Study on heterotopic ossification has suggested that it may be linked to injuries to the spinal cord, along with neurological conditions. It appears that mixed signals in the body stimulate normally dormant osteoprogenitor cells, causing them to start growing bone. When these cells are in the soft tissues of the body, it results in heterotopic ossification. The condition often appears in the form of periarticular ossification, especially around the site of hip injuries.

    When heterotopic ossification is caused by trauma or an injury, it is known as heterotopic ossification traumatica, while a case with no known cause is termed “atraumatica.” Heterotopic bone formation has also been known to strike amputees, especially those who have experienced violent or traumatic amputations such as victims of mines. In amputees, the condition can cause serious problems, as surgeons may have to amputate part of the residual limb to treat the condition, thus making the amputation even more severe.

    While not inherently painful by nature, heterotopic ossification can become painful. Severe cases may restrict the patient's movement, or cause internal bruising and injury. Typically, anti-inflammatories and pain medication will be prescribed to bring the rate of soft tissue swelling down and ease the pain associated with the condition. If it becomes clear that the heterotopic ossification is spreading, the patient will have to have surgery to remove the offending bone material, in the hopes of removing the rogue osteoprogenitor cells. In some cases, surgeons may have to replace an entire joint, if the new bone formation has surrounded or damaged the joint too extensively.
    Last edited by gjnl; 07-16-2010 at 01:14 PM.

  8. #8
    Hi,
    As you can see, there are many different methods to treat a fractured femur ranging from no surgery, varying degress of immobilization to various types of surgery and hardware. Some of this depends on the surgeon as well as your personal health history and level of mobility.
    I would recommend you see an orthopedic surgeon as soon as possible, trying to get one that has some experience of consultation with SCI physician and or physiatrist(rehab doctor). It may be good to get 2 opinions if you feel you need another approach.

    Keep us posted.

    AAD

  9. #9
    sounding ignorant again but is the femur your thigh bone. if so, i just can't understand why it would "snap" from just stretching.

  10. #10
    Quote Originally Posted by rollin64 View Post
    sounding ignorant again but is the femur your thigh bone. if so, i just can't understand why it would "snap" from just stretching.
    That's what I would have thought too, nonetheless mine snapped right in two. Apparently it's not uncommon.

    In my case they think I might have damaged the bone in my original accident, and that it never healed properly. Other people get osteoporosis, and in others the bone atrophies along with the muscles.

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