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Thread: Broken Femur

  1. #1

    Broken Femur

    Hi everyone, My boyfriend is a Quad, C 4,5 and 6. I took him to the ER the other day and he had to have a CAT Scan of his abdomen, the doctor came in and asked us if we knew that his left femur bone was broken at the hip. We did not know this. He has had some pain in the left hip ( he has deep pain sensation) but we thought it was from 4 flap surgeries that he had this past year to heal a would on his left istial.

    They had the Orthopedic docs come in and talk to us. The doctors told us that because Steven does not walk that they would not do surgery. They told us that the break is displaced and that the pain Steven has been having should eventually subside. They then told us to watch out for anything different with this skin on the left him, any redness, bruising and swelling, or anything trying to protrude. they said if these things happen to bring him back to the hospital to see a Orthopedic surgeon. They said that this break didn't just happen, it is an older break but could not tell how hold. Steven has only been having pain in this hip since about October of 2009, which was after his 2nd flap surgery.

    I am really worried about this, Steven has not been dropped, unless he was dropped in the or, isnt it hard to break a femur bone? doesn't it take alot of force? and how safe is it not to have it fixed. Steven has become very paranoid about this, he is scared to have his leg bent at the hip. we use his leg in turning him.


    Just how concerned should we be? any advice would be appreciated.


    Heather
    Care giver to Steven, a Quad with a C 4,5 and 6 incomplete injury.

  2. #2
    Hi Heather,
    I understand your concern about this broken bone. It must be especially upsetting not knowing when it happened. GJ broke the tibia and the fibula in his right leg a few years ago. The orthopeadist didn't do surgery, mainly because of the extent of osteoporosis. The doctor just immobilized the leg in a removable boot type cast. We were very worried about removing the cast to bathe him. The bones healed fairly well in their right place and there is no noticeable deformity. GJ is a C6/7 complete quad and does not have deep pain sensations, but he did have some autonomic response when his leg was manipulated. I have been very cautious about using GJ's leg to position him on his side or roll him while dressing. I think a better way is to bend the knee (in the direction you want to roll or move) then place one hand on the middle of his back and one hand at the hip, just at butt cheek level and either pull or push (depending on direction) to go from his back up on to one side or the other. This way you are using the trunk of the body to move him. Another way would be to use a draw sheet in a similar fashion to the description above. The draw sheet spreads the pressure along the trunk.

    Is there anything that he can take for the pain sensations he has? I hope the pain goes away as quickly as it came.

    All the best,
    NL (GJ's wife and caregiver)
    Last edited by gjnl; 11-06-2010 at 07:46 PM.

  3. #3
    Hi NL, it is very concerning. The hospital did not even immobilize his hip, just stated that they felt it would be ok. we are very careful in turning him and getting him up in his chair. Steven is on pain meds and it takes care of the pain for the most part. The doctors said that the bone had healed where it was..it is displaced so it healed where it was not supposed to.

    Heather
    Caregiver to Steven Quad c4,5,6

  4. #4
    Increase intake caclium and vitamin D
    but the leg must have been injured in some way, but it oesn't have to be a fall, and maybe it was weakened with osteo.But it did healon its own.
    CWO

  5. #5
    Hi,
    You did not mention how long Steven has been injured. Under the best of circumstances, osteoporosis can be slowed but not stopped in an SCI.

    Regarding how the fracture might have occurred, I fractured my femur a few years ago simply by rolling over in bed, not noticing that my foot was caught in the covers and did not rotate with my upper leg. The result was a nasty spiral fracture.

    A common problem is the development of an ossification (mass of bone) around the fracture site, which is the way many SCI fractures heal. If the fracture is close to the hip joint, it can restrict range of motion.

    Has your orthopedic surgeon had experience with SCI fractures? If not, I would encourage you to gt a second opinion from an MD who has, if possible.
    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
    http://cccforum55.freehostia.com/

  6. #6
    Steven has been injured for 25 years. This is the first bone break since his injury. Last year he got his first wound on his ichial, we tried to heal it at home with the assistance of the wound clinic but it would not heal, he ended up having his first flap surgery in august of 2009, his second in october 2009, his third in March of 2010 and fourth in 2010. After the 3rd Steven was able to get into a specialty hospital in SLC for wounds and chronic infections. The infection that Steven had was acidabacter (i am not sure how to spell it), it was the hardest infections to get rid of and took several weeks with several different antibiotics. Maybe the infection made his bones week also.

    I am going to call the Orthopedics dept tomorrow morning and see if they have anyone there that has experience with Paralyzed people.

    thanks for the advise

    Heather

  7. #7
    Senior Member
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    I'm 17 years post injury, and I broke my right femur right at the femoral neck about 7 years ago doing a pushup to get upright in bed from lying on my right side. I went to the ER and the xray showed that it was an older partial fracture that finally completely broke. They also did nothing, so I asked my VA doc about it and they basically agreed that it shouldn't be a problem.

    It was really weird for awhile knowing that that broken bone was just floating around unconnected, but nothing has really come of it except when I'm flat sitting in bed I can point my foot in either direction
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  8. #8
    Hi Donno,

    Thankyou so much for posting. Did you experience any pain with the break? how long did it last?

    Steven is very freaked out that there is a broken bone floating in there..he is very scared of it poking through the skin or even causing a sore in there. I told him that so far we have not had any problems with it, we are not exactly sure how long he has had it except to go by when the pain started.

    We have home health aides that come in and help me for a couple of hours in the morning and at night and they are very careful as am I when turning or repositioning as well as getting him up in his chair. He is very fearful about problems that may occur with this.

    ~Heather~

  9. #9
    Senior Member
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    Heather,
    In the year or so before the bone separated, I would occasionally hear a pop when I did my get up pushup while lying on my right side. On the morning that it happened, I heard the pop, but didn't feel anything (I'm T3/4 complete), but while I was sitting up in bed cathing, I started to get AD, and noticed that my right leg was about 2" longer then my left. I thought that I had dislocated my hip, and called 911. By the time I got to the hospital the AD was gone and I don't seem to have had a recurrence.

    Anyway, the tendons are still holding the femur mostly in place - so the femur won't go very far, and other than not using a standing frame any more. I have not made any changes in my life or activities. I was not really freaked out, more like oogied out - made me feel squeamish until I just stopped thinking about it.

    I'd suggest that Steven just take it easy and wait and see rather than worry until he gets used to it - it *is* upsetting to think about.

    Don
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

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