ORIF Broken Femur/ORIF surgery Dec. 20, 2020.

I’m going to guess that this recovery is somewhat similar to a knee replacement.

This is what I post about a knee replacement:

It was major surgery, and your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more. (I’m not sure, though, if your current recovery can take a year or more, like a knee replacement can, but it wouldn’t surprise me if it might.)

Something to think about.
 
Thank you, probably it is all in the healing process and it's in a different area than the knee replacement. I don't remember being so stiff after TKR, but I do have a long incision from my hip, curving down into the incision for the knee replacement. The break was right above the knee replacement. They are similar, yet different surgeries in the recovery in my experience.

With the TKR, I was walking without assistance 3 weeks after but it's been 4-1/2 months and I need the pole, although the p.t. had me practising without the pole and advising me to engage my gluts. I realized that I can barely feel my left glut to engage it lol. I think you're right, this is going to take at least a year to be back to normal, at the rate my recovery is going.
Oh how I wish I never went out on that dark, snowy, icy night to walk the dog...ugh!:holysheep: I was in such good shape before. We had even booked a bike/barge trip Amsterdam to Bruges, for April 2021, but cancelled due to the pandemic. I had been training in the summer and fall for the long bike rides. I don't care about the trip; I was actually glad we cancelled because an average day of biking was around 30 km. and I didn't think I'd be able to do it.:thud:
 
Hi @liam2015.

I think the stiffness has to be part muscular. As we discussed my wife TPF ORIF she has lost tremendous muscle mass in her affected leg, and believes it will take a year to gain some of the strength and muscle back. She is not back to weight bearing do to her mishap, but a good day in PT yesterday. She is still feeling stiff for sure. We are 12 weeks PO. Even w/o the mishap we thought it would be another month or so before she could have gone to cane and then some period before not using a cane. My wife had been doing pilates reformer multiple times a week, walking 3-4x a week, cycling 1-2 a week and this injury has devastated her from that stand point. We have discussed getting a person trainer several months down the line once she transitions from regular PT. Hang in there, I think key is patience, and doing light activity as your body allows.
 
Thank you @VolFan0927 ~ oh how things can change in just one day, even when we've been keeping fit! Glad to know I'm not the only one with this stiffness. I've just noted to myself that it's not as bad first thing in the morning when I get up; it comes on more after sitting. standing or walking around as the day goes on. Yes, you're right, the key is patience.
 
One day at a time. I just think a femur or tibia break is a bit slower than TKR. Alot of the same rehab, but at a much slower pace. Think you have to get 2-3 months out before thinks start picking up. I do wonder how much improvement occurs from mo 3-12 post surgery. I want to believe, small incremental gains occur, but we will see with my wife. I have read for example that ROM continue to improve in the months after ..say the first 3-4 months,....stiffness also. Curious as how that goes away with time. My wife is stiff in am, but can loosen up during day and can be stiff at night if sitting too much during the day.
 
I have read for example that ROM continue to improve in the months after ..say the first 3-4 months,....stiffness also.
ROM can continue to improve for at least 12 months and many times even longer. We even have one member who noticed that her ROM had improved after 6 years.

Stiffness can take at least 6 months to fade away.

However you look at it, recovery from orthopaedic events (surgery or fracture) takes a long, long time.
 
I saw significant increase in ROM in my second year of recovery, and continue to see improvements in my third year @liam2015
 
Thank you @Celle and @FCBayern ~ good to know about the stiffness being so long-lasting. I don't remember it being like this with TKR as far as stiffness and walking goes. My r.o.m. is coming along much faster than after TKR, but this darn stiffness and soreness in my thigh is annoying. I think I am gaining strength though because I can walk (limping baby steps) without the pole short distances, when working in the kitchen.

Thanks again for the encouragement. :SUNsmile:
 
UPDATE: 5 MONTH SURGEON FOLLOW-UP (Last follow-up was 8 weeks ago).

My surgeon released me today and said the x-rays looked good and was happy to see that I was walking and thanked me for not breaking my leg again lol. I walked in for the first time without being in a wheelchair, into the clinic with my urban pole and out all the way to the parking garage. We were in and out within 45 minutes.

Physio has been about the same: practise walking with and without the pole, massage, TENS, laser and hot packs for around 20 minutes. After I use the stationary bike, for 8 minutes, down from 10 minutes which was too much for me as my thigh complained for a few days. They had a new bike, but I don't think it was adjusted properly to my height, although it felt okay at first. I was quite sore for a few days afterward and didn't do any of the home exercises the rest of the week; just ADL's and resting. I didn't go to physio at all this week, going once next week at the same time as my husband.

I do the home exercises sporadically, except for the bridge because I don't find it very helpful to do it on the bed. I like doing them normally, but best on a yoga mat on the floor ~ I'll get to that soon when I feel confident getting down to the floor and back up. I'm doing well with the wall squats, tip toes, leg lifts to front and side and easy heel slides. I sometimes forget to take the pole with me and walk unassisted, but not properly, but that will come soon. I also have this walking exercise where I lead with my left leg going forwards and backwards which I think helps to strengthen thigh.

My goal for this weekend is to completely make the bed (after it has been stripped), including the fitted sheet. I don't like the way my hubby places the blankets.:gaah: I've been making lunches and dinners every day and cleaning up after. My back gets tired standing. My biggest complaint is the ongoing stiffness after sitting even for 15 minutes but I have been assured that will pass.
 
Hi,
Hope you make your goals this weekend. My wife has stiffness, which is occurring in the evening after PT. When did you start the wall squats? I feel like my wife's ROM improvement is slowed by not being to do exercises that would improve her ROM - outside of cycling?
We may go from 3x to2x PT, as this last week was really tough, and she is alot more swollen - corresponding to alot more assisted walking this week. She is still only 14 weeks PO.
Thanks
 
Hi @liam2015
I do hope I am posting in the correct place and not disrupting someone else’s thread!

I hope you are continuing to improve, reading your story you’ve had quite a journey. The reason for posting is that I think I read somewhere that your husband is also having knee problems, awaiting an MRI? Without trawling through many posts again I think I read that he is having knee bleeds? If this is correct, I just wanted to say that is what happened to me and resulted in RTKR in February this year. The bleeds (haemarthroses), would come on very quickly with no warning and within 15 -30 minutes my knee would be massive. I’m very pain tolerant, but the pain caused by the bleeds was totally off the scale, like nothing I’ve ever experienced. I was screaming and writhing around, fainted once, was sick, diarrhoea, the whole works. On one occasion I had to call an ambulance and went to the hospital ER.

I also had blood drained from the knee. My surgeon and my rheumatologist explained that sharp osteophytes (bony arthritic growths), were catching on tiny blood vessels in the knee and causing the bleeds.There was also an overgrowth of synovium. I also had bone cysts caused by chemotherapy for breast cancer some years ago.

So, I was told TKR was the answer, and I also had a synovectomy at the same time. My OS said there was a big amount of blood debris in the joint, so I’d probably been having lots of minor bleeds as well as the big painful ones.

I’m 14 weeks post surgery and doing very well, back to most of my previous activities including gym, yoga, open water swimming, walking my dogs and caring for my two ponies. So far so good (no recurrence of the bleeds)! Having a scan in preparation for the LTKR later this year - L knee is very deformed bone-wise but thankfully no bleeding.

So, please ignore all of this if I’ve got the wrong end of the stick, but I just thought my experience may be helpful to your husband.

Best wishes to you.:loll:
 
Oh my goodness, thank you for sharing your experience. My husband's MRI has been re-scheduled to June 16. You are so right ~ the pain from the 3 or so relapses he's had was so severe, he was screaming. The first time it happened, he was downstairs and had to come up on his butt. The 2nd time it happened, he was walking our dog and had to phone my sister to pick him up as I was just home from my femur surgery. That time an ambulance came and he went to e.r. The 3rd time it happened again when he was out walking the dog and my sister had to pick him up. This time the ambulance wouldn't come, but hydromorphone got him through.
Since then he has improved a lot since going to p.t. and doing the exercises diligently. His family dr. and p.t. said it was unlikely that he would be a candidate for arthroscopic surgery, that at his age it isn't guaranteed to work ~ if worse came to worse, it would be a TKR, like you said.

Thank you so much for responding. Maybe I should make a thread for my husband to share his experiences. He's been taking such great care of me and the house, now he's back to walking dog and, in my opinion, doing a bit too much. We'll see what happens after the MRI.
 
UPDATE: 7 Months post op from Broken Femur ORIF surgery.

This has been a much longer recovery that the TKR. The upside is that my flexion is good in comparison to TKR, but I am not walking nicely. When I don't use my "urban pole", I have to really concentrate and go slow to walk properly. For around the house, if I don't use my pole, I either limp or "waddle" like a penguin, which is faster to get around. It's my thigh that hurts when I walk ~ not sure if it's muscular or weakness, needing to build strength. I feel lucky that I can walk at all and do all my household chores. I'm not taking any pain medications. I do occasionally put a hot pack on my thigh for relief and it helps temporarily.

Physiotherapy has come to a halt because my husband had an emergency appendectomy on June 29 (a few days before we were due to go on vacation). Prior to the surgery, his oxygen was low so they did a chest x-ray and found he also had a partially collapsed lung (shocking because he has been very active over the years). His appendix had ruptured in multiple places and his intestine was completely covering it ~ "coffin-like" how it was described. I, the patient, am now the caregiver. He only started feeling half decent a few days ago, his oxygen levels fluctuating, getting well below normal, making him feel very weak. I'm happy to say that I've been able to do everything to care for him ~ making sure he eats healthy meals, monitor his temperature (at first it fluctuated between low grade fever and normal) and his oxygen levels. He lost 10 kilos so far, but I think he will gain it back. I've been going up and down to the basement to do laundry and making shopping lists for my sister to shop for us.

Every summer we go for 2 weeks vacation to the countryside, walking distance through the woods to a beautiful Ontario beach (Sandbanks Beach) and rent all 3 units in a renovated barn. Our dog, adult children and granddaughter join us and everyone has their own space - it's huge. This time we didn't go, but they took our dog with them, which was a blessing, with everything going on here and our niece, our temporary dog walker (since hubby injured his knee) started her summer job and was unable to continue. Our dog is back and hubby mostly has been walking him again and I've gone along a few times. I'm not sure if it's safe yet for me to walk him but hopefully, soon.:dogwalk:

The progress is that I have increased my daily activities and I can stand longer now without my back aching. I'm really hoping that my thigh goes back to normal so I can walk normally and walk my dog. I still get stiff after sitting for more than 5 minutes and it takes a while to loosen up ~ what is that all about ~ age maybe?:old:
 
Oh wow, you have been through so much! Scary about your husband, but I’m glad he is doing better, and glad that you are coming along well enough to handle this extra activity. In spite of it all, I hope you are able to get some rest time, too. :console2:
 
Thank you Jockette ~ it's been a challenging year, I'm sure, for everyone. All 3 of us (including our dog) take a well needed afternoon nap so we can stay up later and watch Netflix lol.:sleep::bored:
 
That is great! Big accomplishment. Has your ROM increased? Are you able to drive at this stage?
 
@VolFan0927 ~ thanks, it was a little challenging as I have to walk up one hill to get to the Main Street and back down again and hope that no one else is walking a dog. He was really good but I had him on a tight leash and when I loosen it, he sometimes takes a dash for a tree to pee lol. On the way down the hill, there was a lady across the street, walking a small dog that was barking and lunging at us, and Liam completely ignored him, which was a good thing.

My r.o.m. is probably the same as it was before, around 120 to 125 degree flexion; however, it's my thigh that hurts when I walk, my knee is fine. Using the pole, takes the pressure off a bit and I am walking around the house much of the time without the pole, but limping, which is not good. I haven't been back to physio since hubby had emergency appendectomy on June 29. I have not driven, partly because I'm hesitant and also because it's awkward getting in and out of the car. I'm pretty sure I can do it, but in my own time. I went grocery shopping with hubby first time on Sunday, since Dec. 19 and that went okay. I've been practising going up and down our stairs using both legs, but holding on tightly to bannister on both sides. I do fear putting too much weight on left leg in case it sets me back with the pain. I know I have to get over that fear.
 
Understand completely. My wife is not ready to tackle stairs. We have talked about her trying to start with 1-2 to start getting used to them. Her quad is still super weak and very tight. She has another massage session and first water therapy tomorrow - so hope that will help quad. Are you doing anything specific at home to increase quad strength? Maybe stairs will help the quads?
 
@VolFan0927 ~ Last time I was at physio, I was asking the p.t. about stairs and she recommended practising on shorter stairs. She took me outside and I was able to use both legs going up and down on the short steps without pain. I've been practising going up regular stairs at home (tight grip on railings), but still not confident using both going downstairs. I think this does help with quads as long as I do it gradually.

I have not resumed some of the exercises I was given, ie. wall squats, leg lifts forward and to side and tip toes up and down, partly because I've been looking after hubby since his appendectomy (he's a lot better now) and haven't wanted to experience any lingering muscle pain or otherwise from the exercises. I have been walking a lot in the house, just a few time outside. I might start doing the wall squats again now that hubby is doing better. My thigh seems to be the weak link.

I hope your wife has a good water therapy and massage session today. Keep us updated on her progress.
 

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