[ORIF] Emergency Femur Surgery on 3 Year Old THR

[Ruth123]

My husband fell hard today; x-ray shows compound fracture of the femur where his prosthesis enters it. The radiologist mentions that the prosthesis is intact and not loose at the hip joint.

We live in Mexico and he (and I) had successful easy recovery THR 3 years ago. The same surgeon will operate on him for this 'repair.'

The surgery will be done early tomorrow so he can be off blood thinners a full day.

What sort of recovery should we expect timewise? Mi esposo is very fit, trim and healthy for his age. He walked out of hospital without a walker or cane after his THR.

 

[benne68]

Welcome back, @Ruth123, although I'm sorry it is because your husband fell and fractured his femur.

I did a quick forum search and found some recovery threads by other members who have suffered similar fractures. You might find some helpful experiences by reading through them here.

Even though you and he have been through hip surgery recovery before, I will share our Recovery Guidelines as a reminder. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

HIP RECOVERY GUIDELINES

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy

5. At week 4 and after you should follow this
Activity progression for THRs

The recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

As you know, we try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[djklaugh]

@Ruth123 I am so sorry your husband is having to have this surgery! It is good, though, that is implant is not broken and does not need replacing. How he will recover depends on what the surgeon needs to do to fix the compound fracture. He may need to pit plates around the fracture or do some other type of repair.

I would also guess since he is in good health and has up to now been active, that his recuperation will be similar to what he went through with the hip replacement. Though with a fracture he might need to be non weight bearing on that leg for awhile .... depends on what the surgeon says.

 

[alycat11]

I’m 6 weeks out from femur surgery mine happened a week after thr . First I’m sorry he’s having surgery the pain from a broken femur is intense. My experience is there is not a lot you can do especially at the beginning except let femur heal I couldn’t put weight on it no pt just allow it to heal. Less is better

 

[myglasshalffull]

So sorry to read this.
Keep us updated.

 

[Ruth123]

Surgery done. Xrays show long brace down to just above knee. Lots of screws and wires. Surgeon said hospital stay over weekend at least. Walker needed, no weight bearing for a month other than tippy toes. Will evaluate after a month.

He's still in recovery.

 

[myglasshalffull]

At least the surgery is done. Please give your husband our best & keep us posted on his recovery.

 

[Ruth123]

I’m 6 weeks out from femur surgery mine happened a week after thr . First I’m sorry he’s having surgery the pain from a broken femur is intense. My experience is there is not a lot you can do especially at the beginning except let femur heal I couldn’t put weight on it no pt just allow it to heal. Less is better

What did you find easiest for initial non weight bearing means to get around house? Wheelchair, Transport Chair, Walker or Crutches?

 

[newguy]

Oh man , my fear is falling. Sending good vibes !!

 

[benne68]

What did you find easiest for initial non weight bearing means to get around house? Wheelchair, Transport Chair, Walker or Crutches?

If he is weak from the surgery or the medication, you may want to opt for a wheelchair for the early days, and then switch to the walker.

Personally, I prefer the walker over crutches because it provides for better balance -- and the last thing you want now is another fall.

Keep us posted.

 

[alycat11]

I used a walker if he can put any weight on his leg I think that’s the easiest. If there is any weakness use a wheelchair no reason to test the waters . It takes a minute for femur to heal. Hope it’s going well

 

[alycat11]

Also I was discharged on day 3 after surgery it was a little early for me I could have used a couple more days. I wanted to go home as we all do but make sure it’s the right thing. Good luck

 

[Ruth123]

His surgeon came by and said nothing weight bearing on operated leg than tippy
toes for equilibrium, for the first month. 2nd month he goes to 50-50 and hoping full ability at end of 3 months maybe 4.

The wound looks good. He explained that other than no weight bearing he wants him to do some light exercises.

PT came for a few light exercises, applied ice packs and electrodes to stimulate muscles.

The surgeon had him move his legs to side of bed and helped him stand in walker. He just started to have him take a few steps when the aides arrived to take him for an MRI to rule out brain issues as to why he fell. I just saw the report and seems mostly good, but my "medical' Spanish is no where near my restaurant and travel Spanish.

They also put him on a Holter monitor last night per his cardiologist's request. He has been in Heart Failure for 3 years, surprisingly he remains asymptomatic.

Before the surgeon arrived, I went to nearby Medical Supply store and that took a huge load off my mind. I have been to other type stores here in my village and usually what you want, they don't have. But this place has it all, rent or buy. They also gave me prices on home nurses. Not as cheap as they once were, but much better than in US. Appx, 18 USD equivalent per hour.

 

[alycat11]

You have such a great attitude your husband will heal much easier with you helping . Like I said I’m 6 weeks out from femur fracture surgery I’m much better but still not as independent as I would like my next meeting with my doctor is on Xmas eve hopefully more restrictions will be lifted or lightened up. I keep reminding myself that this to shall pass . After my first week I couldn’t fathom getting to 6 but here I am . Remember to take care of yourself!!

 

[Ruth123]

You have such a great attitude your husband will heal much easier with you helping . Like I said I’m 6 weeks out from femur fracture surgery I’m much better but still not as independent as I would like my next meeting with my doctor is on Xmas eve hopefully more restrictions will be lifted or lightened up. I keep reminding myself that this to shall pass . After my first week I couldn’t fathom getting to 6 but here I am . Remember to take care of yourself!!

How did your appt. go?

We got home earlier today, mi esposo via ambulance. Set him up in recliner where he'll sleep, at least for a few nights. He uses walker to steady himself but only hopping one or two steps, still a bit shaky, tired. He's got good upper body strength but being mostly flat on back for 6 days has weakened him considerably. And absolutely no sleep those 6 days; you know how it is in hospitals!

Had PT before we left hospital, it's focused on muscle rehab, not the femur itself. He will get 5x a week PT starting 12/26 at home.

His wound is still weeping, not the long incision, the short one next to knee (and that's where most swelling is). One of the nurses from hospital will come every 3 or 4 days as needed to change dressing.

He sees surgeon on 1/2/25; the surgeon had said he could ride in car, but biggest hurdle will be getting to the car. There are 3 steep and very narrow steps down. And this old MXN house wasn't built for our SUV and it's very tight on both sides. He would have to navigate thru garage to street to open car door fully. Oy!

We don't have any home care folks yet....with the holiday, here in MEX everything closed today and tomorrow. Will just lay low until the 26th. At least we are both less stressed being home, but still stressful enough!

I hope you had good news at the Dr's today.

 

[myglasshalffull]

Happy you & your husband are at least home & can relax a bit until holiday is over.
There's no place like home!
Merry Christmas!

 

[Layla]

I agree that the situation involved getting your husband down the stairs and into the SUV is not ideal this early on. I wish you luck.
Merry Christmas! I hope you both have a peaceful day. @Ruth123

 

[Ruth123]

We've muddled through the holidays solo, though the holidays aren't over until Jan. 6th which is Día de Los Reyes Magos (Day of Wisemen) and still the day most MXN's exchange holiday gifts. At Los Reyes parties, they serve a Rosca de Reyes which is similar to King's Cakes in New Orleans. The roscas have a plastic Baby Jesus in them and if you are lucky (??) and get it, you have to provide the tamales on Día de Candaleria in early February.

He is having 3x a week PT (well, 2 a week so far, due to holidays). His nurse from hospital changed his dressings and cleaned the incisions every few days since discharge.

Today the surgeon came to house to remove staples and stitches. Did an exam, asked my husband to show ROM. The big hiccup is swelling fluid around knee-cap which keeps him from bending the knee, and impinging on movement. Dr. said it's normal and will improve with time and continued PT. Still no-weight-bearing for 3 more weeks at least.

Nice visit with surgeon who has done 3 surgeries on me (THR and each of my hands for Dupuytren's). He also did my husbands THR. It was a boost to both of us, having some reassurance.

 

[mendogal]

I'm so pleased even the surgeon did a home visit!!!

Yes the swelling will take quite a while - best to not let PT ever force the bend as that will immediately create a setback in terms of inflammation and swelling. Ice and elevation will continue to be helpful for many weeks.

Ojalá que su recuperacion siga siendo suave.

 

[Layla]

It was a boost to both of us, having some reassurance

Good! Happy to read this. There's nothing like a reassuring nod from the surgeon.
Enjoy the upcoming parties and gifts!