Thighbone > Treatments
Open Reduction and Internal Fixation
In an open reduction-internal
fixation surgery, an incision is made and the broken
bones are realigned by the surgeon.
anesthesia is typically used for surgery, though in
some cases, a spinal or epidural anesthetic is used.
The anesthesiologist administers the anesthesia to put
you to sleep in the operating room.
procedure usually lasts less than two hours. One incision
is generally made to expose the area of the fracture.
The fractured pieces are held together and secured by
metal wires or screws, which remain unless they cause
discomfort or pain.
the bone is set, the incision is sewn up, an immobilizer
or cast is placed on the leg to restrict movement, and
the patient is taken to the recovery room.
After surgery to repair your fractured
thighbone, you usually will stay in the recovery room
for at least two hours while the anesthetic wears off.
You will be given pain medicine, either orally or through
an IV (intravenous) line, as well as instructions for
what to do over the next couple of days. In addition,
you will be given an appointment to return and a prescription
for pain medicine. When you wake up, your leg will be
immobilized and bandaged. You may experience significant
pain early on and you should take pain medicine as directed.
Because it is easier to keep pain suppressed than it
is to treat pain once it present, take pain medication
as directed, and do not delay your doses. You should
try to move your feet while you are in the recovery
room to improve circulation. Your temperature, blood
pressure, and heartbeat will be monitored by a nurse,
who, with the assistance of the doctor, will determine
when you are ready to leave the hospital or, if necessary,
be admitted for an overnight stay.
| Post-op in Hospital
After open reduction and internal
fixation to repair a fractured thighbone, most patients
remain in the hospital for at least 24 hours. There
will likely be pain, and you can expect to be given
pain medication as needed. Be sure to ask for medication
as soon as you feel pain coming on, because pain medication
works best on pain that is building rather than on pain
that is already present. Your physician will monitor
your pain medication both in and out of the hospital.
Ice also helps control pain and swelling. Since you
will not be able to drive, make sure to arrange for
someone to drive you home.
After a thighbone fracture, it is important for you
to monitor your condition and take specific precautions
to protect the leg and speed recovery. If you require
surgery to treat your fracture, things to watch for
the swelling decreases dramatically, especially during
the first 48 hours after surgery, your brace may become
too loose. If swelling increases, your brace may become
too tight, and circulation can be dangerously cut off.
In both cases, you should contact your physician immediately.
from the incision are typically removed after about
two weeks. During this time, it is important to keep
the incision clean and dry to prevent infection and
speed healing. Your physician or nurse will instruct
you on how to care for your incision.
rash or irritation around your brace may indicate poor
fit or sensitivity to the materials. If you develop
a skin irritation around your brace, contact your physician
will probably experience pain for the first few days
after surgery. This pain can generally be adequately
controlled with the pain medication prescribed by your
physician. If the pain does not gradually decrease within
a few days, contact your physician.
Patients with open thighbone fractures typically wear
a braces for four to six weeks. Because your mobility
will be limited during this time, it is important that
you take special precautions. Elevating your injured
leg above heart allows gravity to help reduce swelling
and fluid accumulation. Place a stack of pillows under
your ankle while you are lying on your back. Moving
the toes of the injured leg improves circulation throughout
the leg. Straight leg raises are one way to strengthen
the thigh muscles, and are usually recommended one or
two days after surgery.
to call the doctor after surgery
Once the pain and swelling associated with a fractured
thighbone have subsided, your physician may recommend
physical therapy to help strengthen the muscles around
your knee and improve your knee's range of motion. Though
everyone's rehabilitation program is slightly different,
physical therapy for a fractured thighbone follows a
general pattern. Range of motion is extremely important.
Movement may be painful at first, but it is important
to not allow the knee to stiffen. Rehabilitation typically
includes resistive exercises - those involving weights
- to keep the muscles around your knee strong. You should
eventually be able to resume functional activities like
stair climbing, single leg support, swimming, and driving.
You will be able to begin more vigorous activities as
your fracture heals and your leg gets stronger.
strengthening exercises: Thighbone fracture
Once your fractured thighbone has healed, building muscle
strength around your knee can help you avoid further
injury. Contact sports and activities increase your
chances of re-injuring your knee. Many of the exercises
and activities that are popular for fitness put stress
on your knees. To prevent further knee injuries it is
important to learn knee-sparing exercise techniques
by dividing your activities into three components:
Living - the average person takes between 12,000 and
15,000 steps a day, exerting a force between two and
five times your body weight on your knees. After a knee
injury, take it easy on your knees during the day whenever
possible to save them for activities and exercise. Avoid
stairs when there is an elevator, take the shortest
path when walking, and consider wearing athletic shoes
designed to absorb shock.
Strengthening/Conditioning - activities themselves are
not a substitute for conditioning. Adhere to the muscle
strengthening program you learned during your rehabilitation
program. The best strengthening programs are low-impact
and non-weight-bearing, like stationary bikes and certain
weightlifting programs, because they do not force the
knees to absorb excessive shock and take stress off
- your sport or activity of choice helps maintain mental
and physical well-being, but it is not a conditioning
program. Sports that require twisting and quick direction
changes put great strain on your knee, increasing your
chances of reinjury.
A discussion with your physician or physical therapist
can help determine the appropriate exercise program
and activity level for you.
A small amount of pain is normal during physical activity,
but if you feel so much pain in your knee to warrant
taking pain medication before an activity, you should
consider cutting back or stopping. Pain can also indicate
reinjury. Do not play through the pain after a fractured
thighbone - it may be a sign that your activity is putting
too much stress on your knee. If you are unsure of the
safety of an activity, discuss it with your physician.