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View Full Version : A character has a broken femur...



elissa
07-11-2008, 06:38 PM
and has had to have surgery to repair the fracture. She's recovering now, and would like to take a ride in a wheelchair. What position would her leg be in? Would it be casted? Bandaged? It's only two days since the surgery, but she just wants to get out of the hospital room a little.

Thanks so much!

sheadakota
07-11-2008, 06:55 PM
If she has had surgery to repair the fracture than I am assuming it is pinned internally therefore no cast needed. She would have about a six inch incision on the outside of her thigh with sutures- the leg would be swollen and painful, but as long as the femur is the only bone in that leg fractured, she would be able to bend it but would probably feel better straight out in fron of her in a wheelchair- Keep in mind though, the femur is the strongest bone in the body, if she broke that it is likely she has other injuries as well.

elissa
07-11-2008, 07:25 PM
Thanks, that's kind of what I thought. Hmmm, about the other injuries. She stepped on a pair of roller skates on a staircase and landed with her leg twisted underneath her. So far, she's been crediting the basket of dirty laundry she was carrying with cushioning her from other injuries.

HeronW
07-12-2008, 05:35 PM
Depends on the break in the femor--that connects to the thigh, sticks out as a knob to the side and angles down in to the kneecap. If the break is just below the knob she'd be flat on her back until it healed since there'd be ancilliary tendon damamge with connections to the hip. If the break is closer to the knee, likely a full leg cast so the muscles remain immobile allowing healing without stress. New casts are inflatable, immobilizing without the weight of the old plaster ones, and they can be removed for washing the leg.

Mr Flibble
07-12-2008, 09:24 PM
A friend of mine broke his femur falling down stairs ( he only had a few bruises elsewhere, but I suspect the booze made him bounce more readily)

As Sheadakota said, he had no cast, just a gruesome scar from where they pinned it, bandaging, and a pair of crutches. He was back in the pub three days later :)

ColoradoGuy
07-12-2008, 10:17 PM
Just confirming what others have said -- internal fixation of a femoral fracture, either with pins/plates/screws or with an intramedullary rod, has no cast afterwards. Nearly all older children and adults require this form of treatment. Depending upon the details, sometimes younger children are treated only with casting and no surgery.

willfulone
07-12-2008, 10:22 PM
When bro had this done, he required no cast. But, he did not make it 2 days in his hospital room either. They had him up on crutches and moving about within 24 hours and he was out of the hospital before 48 hours was up using his crutches. He never used a wheelchair, except to leave the hospital.

Tsu Dho Nimh
07-13-2008, 07:22 AM
and has had to have surgery to repair the fracture. She's recovering now, and would like to take a ride in a wheelchair. What position would her leg be in? Would it be casted? Bandaged? It's only two days since the surgery, but she just wants to get out of the hospital room a little.

Thanks so much!

Broken femur? Day two? She's loaded to the gills with pain relievers and muscle relaxants and doesn't give a damn where she is.

She's in ICU. She's in a sling with traction weights and steel pins are stuck through her leg with rods holding the bone in position. She has a surgical gash from knee to crotch to release the swelling in the muscle, with a tube draining off the oozing blood. They'll set the bone later when the swelling goes down.

She has a catheter stuck in her bladder, is hooked up to a heart monitor and has a couple of IVs running. The staff is watching her intently for signs of infection and blood clots. She's probably on anticoagulants, IV antibiotics and oxygen.


Now ... about that wheelchair? Maybe a nice broken tibia instead?

ADDING: A mid-shaft femur fracture is what we fear most on ski patrol. They get the helicopter, the ace patrollers (if we can) and I never want to see another one.

ColoradoGuy
07-13-2008, 07:30 AM
Broken femur? Day two? She's loaded to the gills with pain relievers and muscle relaxants and doesn't give a damn where she is.

She's in ICU. She's in a sling with traction weights and steel pins are stuck through her leg with rods holding the bone in position. She has a surgical gash from knee to crotch to release the swelling in the muscle, with a tube draining off the oozing blood. They'll set the bone later when the swelling goes down.

She has a catheter stuck in her bladder, is hooked up to a heart monitor and has a couple of IVs running. The staff is watching her intently for signs of infection and blood clots. She's probably on anticoagulants, IV antibiotics and oxygen.
No. Really, no. Uncomplicated post-op internal fixations of broken femurs are typically not that sick.

elissa
07-13-2008, 08:23 PM
Hmm, quite a bit of differences here. I did research a couple of surgeries, and they said probably some IV painkillers and maybe a need for oxygen. Several places said 1-3 days hospital stay. Hmmmmm...very interesting.

sheadakota
07-13-2008, 08:45 PM
Broken femur? Day two? She's loaded to the gills with pain relievers and muscle relaxants and doesn't give a damn where she is.

She's in ICU. She's in a sling with traction weights and steel pins are stuck through her leg with rods holding the bone in position. She has a surgical gash from knee to crotch to release the swelling in the muscle, with a tube draining off the oozing blood. They'll set the bone later when the swelling goes down.

She has a catheter stuck in her bladder, is hooked up to a heart monitor and has a couple of IVs running. The staff is watching her intently for signs of infection and blood clots. She's probably on anticoagulants, IV antibiotics and oxygen.


Now ... about that wheelchair? Maybe a nice broken tibia instead?

ADDING: A mid-shaft femur fracture is what we fear most on ski patrol. They get the helicopter, the ace patrollers (if we can) and I never want to see another one.
ICU for a femur facture? Only if that was not the only injury and the patient required intabation and was unstable. what you are describing is a complication requiring a fasciatomy- when the tissue swells and must be cut to reduce pressure to save the limb- this is the exception not the norm

Tsu Dho Nimh
07-13-2008, 10:13 PM
I'm biased ... I used to work in a trauma center.

Now I see the ones who cartwheel down a black run and bounce off a tree, landing in a stack of boulders.

Kalyke
07-13-2008, 11:11 PM
femur breaks are very dangerous too. And I think it would be IM nailed. Not a doc here, but I have heard that the break tends to swivel if torqued the wrong way so they have to do some screwing too (like a lazy suzan with one part of the leg going one way and one going the other.) The problem with possible escaping marrow, and also the fact that a major artery is right there makes it very dangerous. If it is comminuted ( lots of fragments and not a clean break) it is even worse. When a bone is broken it is razor sharp until the osteoblasts "soften the edges," so you can literally cut yourself up inside (it happened to me because my leg twisted around when it broke). I sort of side with the folks who say more than 3 days in the hospital. Also the wasting and muscle loss really takes a lot of your energy, as your leg literally eats up all building supplies in the area. I don't see how people can get up after only a few days. Maybe someone with a crack, but not someone with a break that requires nailing. The majority of your energy, liquids and building supplies goes to the injured area, and the pain is intense . you are totally jacked up on hydrocodone or something for at least a week after, sometimes 2. Oh well, I'm not a doctor or nurse and have only had broken tib/fib, so I'm just adding my 2 cents worth.

ColoradoGuy
07-14-2008, 01:48 AM
I'm biased ... I used to work in a trauma center.

Now I see the ones who cartwheel down a black run and bounce off a tree, landing in a stack of boulders.
I'm not biased -- I have several decades of personal experience. As sheadakota pointed out, certainly a femoral fracture in association with other injuries (or with preexisting health problems) can land someone in an ICU, but that is the exception.

Kathie Freeman
07-14-2008, 07:16 PM
The weakest part of the femur is the neck - the part between the bend and the ball. I broke mine falling off a bicycle. Surgery to put in a plate/rod, 2 days in bed w/ a catheter, no iv, fully awake and pissed off. After 2 days, a walker and orders to walk. Problem was, the muscles in the broken leg didn't respond to commands and it took months to get back to full strength.