Fear of non-union of femur is driving me crazy : please help

Hi,

This is my first post in this forum. :)

On February 17th I broke my femur along with 6 ribs, the clavicle and the wrist. I fell off from 15-20 feet straight on the ground. On Feb 22nd, the surgeon fixed my femur with an IM nail, with 4 screws; 2 in the top and another two in the lower region. My fracture was a severely comminuted one.

Now it's already been 18 weeks post-op. I have done regular PT since 5th week post-op, and have been walking with a single crutch since 8 weeks post-op. Presently I walk with a limp without the crutch. The limp is due to a dull pain in the inner thigh region.

What I'm worried of is that I feel, and can see that there's still quite a visible fracture line in the femur. I am attaching my latest x-rays which were taken 15 weeks post-op (one month back). Sorry for the image quality, they were taken by a mobile cam. :(

Attachment 1171Attachment 1172Attachment 1173Attachment 1174

The doctor said there was enough callous formation and I should leave the crutch and be FWB. When I asked about the fracture line, he said it will completely heal within a year.A second doctor also said the same thing. But I am freaking out in the case of a non-union. I am about to enter a new job within 2 weeks, and thats far away from where I've been staying now. The thoughts of needing a second operation, bone grafting etc are having me worried all the time. I must say I have very manageable pain in the thigh region, with no knee pain whatsoever.
Please have a look at the x-ray images and help me with your expert opinions. Do ask if you need more information.

Thanks in advance!

Hi there,

I am not an expert however can I ask how much pain you are in when you weightbear? i.e out of 10 with 10 being pain that you require hospital admission.

Thanks

Quote:

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Originally Posted by kwunfu

Hi there,

I am not an expert however can I ask how much pain you are in when you weightbear? i.e out of 10 with 10 being pain that you require hospital admission.

Thanks

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Hello,

When I'm walking, if I limp, then there's not much pain....maybe 3/10 if I walk for 20-25 mins straight without a crutch.
With a crutch, pain level is 2/10 after 35-40 mins.

If I want to walk without a limp, I feel a dull ache in my inner thigh, which can be rated at 6 or 7/10

I would highly recommend seeking an orthopedic surgeon advice. I can not comment on the Xray or callous formation however after 3 months I would expect less symptoms and a better ability to walk. It may be that you require further strengthening i.e. squats and gym work however not seeing your condition I can not comment. Please do not be too concerned but do seek further opinion from an orthopedic specialist. Even in Australia I have had to send my patients for 2nd or 3rd consults.

Quote:

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Originally Posted by kwunfu

I would highly recommend seeking an orthopedic surgeon advice. I can not comment on the Xray or callous formation however after 3 months I would expect less symptoms and a better ability to walk. It may be that you require further strengthening i.e. squats and gym work however not seeing your condition I can not comment. Please do not be too concerned but do seek further opinion from an orthopedic specialist. Even in Australia I have had to send my patients for 2nd or 3rd consults.

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Yes, I'll visit my orthopaedic surgeon tomorrow, who was not concerned that much about limping, when I saw him the last time. He said that to walk normally I might need 12 months.
Thanks for your suggestions mate.

@others: if someone can comment on the X-rays it'll be really helpful.

From the Xrays there is some callous formation which means some bony growing and acceptance of the metal work. Please do not be so set on what the Xrays show or do not show as there is a lot of science telling us now that Xrays or imaging does not necessarily correlate with symptoms. I would be more working on you strength and movement deficits as it sounds like when you correct your gait it causes more symptoms. This suggests that your leg muscles especially your gluteals and hamstrings may be fatiguing causing loading on your limb that is still healing.

Again I do recommend a second orthopedic consult if you are still concerned particularly if after 4 months post operation you are still experiencing the same symptoms you have described.