Recovery: 9 year old has slight limp 9 weeks post femur fracture

[jtcavers]

Hello and thanks in advance for your time.

On Sept. 28, 2011 my 9 year old son Jacob suffered a spiral midshaft fracture of his left femur when he collided with a teammate at hockey practice. Prior to the injury he was a healthy and very fit young man that played multiple sports at a very high level. It was repaired at Sick Kids hospital in Toronto on Sept. 30 using titanium elastic nailing. Had no perioperative complications other then swelling around knee and thigh, the majority of which subsided within 2- 3 weeks. I have included his last x-ray taken on Nov 8th.

His recovery has been going well. We have been doing the ROM and strength exercises program made for him by the physio at sick kids hospital since week 2. At 5 weeks he was partial weight baring using a walker and at 6 weeks was able to walk short distances independently. He is now 9 weeks post surgery and is very active, walks up and down the stairs in our home 15 times X 3 times a day to build strength, has not required assistive devices to ambulate for over 2.5 weeks, swims twice a week and walks over a 1.5 km three times a week....all without any pain or difficulty.

My concern is his limp. He still walks with a slight limp that over the course of the last two weeks has greatly improved and has become less noticeable, but it is still there HERE is a link to a video of him walking a few days ago.

On assessment he can move the affected limb with good control. Two exceptions. First is when seated in a chair and asked to extend the left leg until straight he can not straighten the leg completely and can only bring it to 165 degrees. The second is he can not bring his left foot all the way back to his bum yet and can only manage to close the angle to approx. 30 degrees or about 4 inches away.

MY QUESTIONS:

-Will it go away on it's own?
-Are there exercises we can do that can help reduce/remove the limp?
-I think his inability to straighten the knee is causing the limp. Does that sound possible and is it possible that this is caused by weak quads/hip flexors?
-What is the typical time to regain strength and range of motion?
-He has not been going to Physio as our surgeon said it was not needed...should he be?

We meet with his surgeon for what he expects to be the last time on Dec 13, 2011. Any questions I should be asking him?

Thank you SO much for your time and effort and I look forward to your response.

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