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Broken Femur, Non Union, Bone Graft

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I was in an auto accident on April 2, 2012. I sustained a shattered femur on my left leg. I had surgery on it that night and had a titanium rod placed and 4 screws total. 1 week later they went back in and lengthened the rod because my leg was over an inch shorter than the other.I was non weight bearing from April 2-July 3 2012. I had absolutely no healing and was missing a large segment of bone. They called it a non union and took me into surgery on July 3. They pulled the titanium rod and replaced it with a longer,fatter one with 4 screws. He also did a bone graft with the marrow he got from drilling further into the upper part of my femur. I am now just over 1 week post op. I am feeling extremely frustrated and scared that it will not heal again. Has anyone on here had any experience with bone grafts in the femur or non union fractures? If so, how long was it before you noticed any callus forming? I am so beyond over this injury and want my life back. I miss being a mother to my boys and a wife to my husband. Any feedback would be greatly appreciated. Thank you!
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First Helper User Profile brokenmommy
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replied July 12th, 2012
Especially eHealthy
brokenmommy,

Actually, by definition a fracture is not a nonunion till six months have passed without the bone healing. Probably, in your case, the surgeons felt that since you have little bony contact, it was not worth waiting the full six months, and it was prudent to go ahead and get the bone to bone contact needed for fracture consolidation.

It is not uncommon, though, for femur fractures to take a good three months to heal (even those that are transverse or short oblique, with good bone to bone apposition). Then, it usually takes about 3 to 4 months to rehab the soft tissues. And, it is common for patients to not have fully recovery for as much as a year to 18 months after a femur fracture. (That is not to say that the patient is laid up totally for that long, but that it takes that long till a final outcome in known.)


But, this is still better than having to go through how femur fractures were treated not too many years ago, when the patients where in skeletal traction for 3 to 4 months. That was followed by spica casting (body cast from nipples to toes) and mobilization on a tilt table. Once the fracture was consolidated, a fracture cast-brace was applied and the patient could finally start getting up with a walker (at about 6 months after the injury). And, this was all in the hospital, on the orthopedic traction unit. This is still the standard of care in some places in the world.

So, with IM nailing, it is great that the patient can get up, go home, and begin working on hip/knee range of motion, very quickly.


Now that you have had the bone grafting and replacement of the nail, the bone should start laying down callus pretty quickly (a few weeks). The bone graft brings in the osteoprogenitor cells that are needed to jump start the healing process, as well as scaffolding for the new bone to grow upon.

In the bone grafting procedure, any fibrous tissue is removed from the fracture site, the fracture fragments are cleaned back to bleeding bone, then the gap left is packed with the bone graft. So, you now have bone to bone contact. Again, it will take a few weeks to see any new callus formation.


In the mean time, follow your surgeon's instructions about weight bearing. Work on knee range of motion, so that the muscles around the fracture do not scar down. This is common cause of decreased motion in the knee after significant femur fractures. The soft tissues around the fracture are also damaged in the injury and they heal with scar tissue. And, now that you have had surgery there also, that stimulates more scar formation. It is not uncommon to have a big ball of scar tissue, which can bind down the muscles, not allowing them to slide like they should during knee motion.

Eat a proper diet, with extra protein. Also, take in extra calcium, vitamin D, and magnesium. The best place to get the vitamin D is from the sun. You can get the necessary daily vitamin D by being in the sunlight for 30 minutes a day. It is a good reason to get out of the house. This is not a good time to go on a calorie restricted diet. You need the calories and protein to build the tissues you need to heal. You need the serum albumin (special proteins in the blood) to heal.

Do Not Smoke. Smoking is the single most detrimental thing there is to bone healing. So, if you do not smoke, great. If you do, it is a good reason to stop.


So, the bone grafting should take care of the problem. You will have to be a little patient though, as it will take a few weeks before any callus is visible. But, that is not to say that the bone is not healing. The body lays down osteoid first (which is the "glue", the soft tissue matrix of bone, that first holds the bones together), then adds calcium to it, to make the callus (new bone).


Hang in there. You still have a ways to go yet, but this should get you started down the right track. Good luck.
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replied July 12th, 2012
Wow, thank you so much for such a detailed answer. I really appreciate it. I m being careful and I am trying to be patient. I think that is the hardest part! I am definitely not a smoker, so it seems I have that in my favor. Thanks again for the advice!
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replied July 7th, 2014
Hi there interesting to read your story. I had a horse fall on me on a road resulting in long spiral fracture of femur in early Feb 2014 also broke ankle calcaneus and malleus ?sp.
Ankle healed but non-union of long spiral so am looking at bone graft in near future so fingers crossed am sick of being patient and want to get on with life.Having read both your posts..there is hope.
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replied May 10th, 2014
Hi there, I was in a RTA Sept 2013 and broke my 2 femurs, and my left tibia, myyleft humerous and I also had a C7 neck fracture with 2 bleeds to the brain. This happened in Portugal and I had all my surgery there. I was there for 5 weeks and then transferred back to Ireland. I know I am very lucky to be here at all!! Can you tell me how your femur has healed? I have lost so much bone that they are now considering a bone graft to my left femur. I have had a procedure called "Dynamisation" and have been sent home with a little ultrasound machine that I have to use on my leg for 20mins per day. I was non weight bearing for months and I can only walk with the aid of a crutch. My right femur has healed fine albeit a small loss of sensation and stifness.I also have a rod in my right leg! Like you I just want my life back and find it hard to see any light at the end of the tunnell. Are you doing ok now? Are you left with a limp? I would appreciate any information that you can give me. Thanks
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replied May 10th, 2014
Wow, Irishmam, that is just awful for you! I did end up having the bone graft in July 2012 because my femur had zero healing. It was very painful, but it was the best thing they could have done for me. I am happy to say that I am 100% healed. I have no limp at all and I am back to wearing my 6 inch heels. The recovery time after the bone graft was about 6 months due to my knee being completely frozen. I still have the titanium rod in my leg and I more than likely always will. I am ok with that considering everything that could have been. I wish you nothing but the best in your recovery, and I honestly hope you do get the bone graft. I started healing within a week of mine. Best of luck to you and hang in there!
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replied May 12th, 2014
femur fracture
Wow, I am glad I found this site. I fell and fractured my femur between my knee replacement and hip replacement. Its a subchondral fracture and after a year is only healed in one place. I have a rod with screws going into my knee replacement. I am scheduled for a bone graph and revision (replacing a screw that was hitting a nerve for almost a year) and very nervous because I too have had my life on hold with this. I still walk with a crutch (in public) because the leg does not feel strong to hold my weight and cannot afford to fall. I also ended up having osteporosis which I didn't when this started so now I am on this awful medicine for 7 weeks which has cause more problems with my gerd and stomach pain. Recently I just went to the dentist and he questioned why I was on this considering I was going to have a graph done and this medication is known to have difficulty with bone healing???? Sooooo confused? Go on the meds so you don't fracture yet thats a side effect anyway? Surgery is next week so I need some perspective.
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replied May 13th, 2014
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@Brokenmommy - I have a question regarding your injury… in looking at your X-Ray, I see they used a nail to connect the Femur back together, but there were so many big pieces floating from it being shattered. I’m no doctor, but from all my reading the past 11 months, I am curious why they didn’t plate the big pieces in place? In doing that, it would then assist with the molding of the bones quicker?

I am super intrigued since my accident. And on a side note… so glad you are back 100%. I’m going to be a year the end of this month, and still am dealing with a lot of pain, and great discomfort when I walk.

~Becca
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replied May 19th, 2014
Oh we are a right lot!! Brokenmommy I am so pleased that you are doing well and back in your high heel! One must get their priorities right! I was back at the hospital this morning for stitches out! I was told that after 100 uses of my Exogen machine they should be seeing something if it's going to work for me. I am only on it 2 weeks now so back in 2 months for a review. It will be a graft then if no change. Letitgo can you ring your surgeon for a chat and speak about your concerns? It is all very confusing and funny enough I have been taken off my anti-inflammatory tablets as they prevent bone healing too! I hope you get the answers you are looking for. Thank you for reply Brokenmommy, it was much appreciated.
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replied February 2nd, 2015
Gday Irishmam. I currently have a broken femur that isn't healing after 5months. I am now facing the choice of surgery and a graft or getting an exogen machine and giving that a go. How are you getting on with your exogen machine. Can you recommend it?
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replied February 9th, 2015
Hey Cam
Motorcycle crash last May- shattered femur and crushed spine. Had a 12" titanium plate with 13 screws in leg. After 6 months it did not heal, very painful. on 1/14 they went in a removed the hardware, did a bone graft from the same femur and put in a smaller plate with only 4 screws. After 28 days it is still really sore and stiff but feels solid. BTW: it is very painful right after the surgery for about 2 weeks. As for the back, I go in next week to have all the hardware removed due to pain. Hopefully good as new by Spring!
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replied August 5th, 2014
Femur bone grafting heal
@Brokenmommy

Hi.. Hope you are doing good.I had a same problem like yours. I met with a major accident and broken two femur bones on 5th sep 2013. My right leg healed well.I underwent bone grafting surgery on my left leg on 10th July 2014.I am using crunches now.There is still swelling around the incision area.I am giving 50% weight bearing.When i try walking without crutches,I limb and feel difficult.I am worrying that i will walk like this in the future.I have a 7 months baby and i am unable to carry him.Its been 30 days now. Haw long will it take to heel. What difference i should feel.Please help
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replied October 13th, 2014
On Oct 14th I was riding my motorcycle with a cop behind me on a back road in pa. The cop was the only eye witness to a 4k Lb suv turning in front of me, hitting me with the the front of her suv she broke my left body basically. I been through alot this last month. Being 24 I missed my daughter's 7th birthday. Tomorrow is one month. My concern is that it's been a month an I have to wait to mid December for my next surgery. I'm currently in bed almost 24/7 I'm missing about 4 inches of my fembur bone directly above my knee. The x-ray copy I have is disturbing to me. Looks like a triangle of metal an the bone should be in the middle connected to my knee.

I don't understand why I have to wait to December (3 Month ) to get my bone transplant an bone marrow done. As I'm in bed typing now. My right leg is about 2 inches longer an it's so scary to look at. Has anybody ever herd of waiting in bed 3 months with a portion of the bone completely missing. I don't understand the wait...could it be, because the incisions have to heal? They took out approximately 130 staples 5 days ago. I have always appreciated life an people why this happened to me I hope one day down the road I'll know. For now it's an unfair mystery. The surgeon I remember him telling me I may not walk to a year or 18 months. .that puts me at living in fear an scared all the time. Do you think my legs will match height when they complete the bone transplant an bone marrow surgery an is it possible to heal without a limp. I'm 24..my daughter I live for...she loves school an soccer. I want Nothing more then to be back in the tard at the field with her practicing. Any feedback will be very much appreciated. Thanks
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replied October 13th, 2014
September 14th was my accident. .sorry ^^
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replied July 14th, 2015
worried about femur and hip soreness.
Hi,i am Neil, on holiday in Thailand and fell and broke my femur up near mu hip they had to replace my hip and put a plate with screws to hold it in place near my knee and wire at the top,i am now 8 weeks post op and still have soreness to touch at the hip and around the bone area were the fracture is also a lot of clicking and movement there as well ,i am full weight bearing,the last X-ray was done at 4 weeks and there was no sign of any union.Has anybody had these problems. i don't know whether to rest or carry on.
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replied July 14th, 2015
Hi,i am Neil, on holiday in Thailand and fell and broke my femur up near mu hip they had to replace my hip and put a plate with screws to hold it in place near my knee and wire at the top,i am now 8 weeks post op and still have soreness to touch at the hip and around the bone area were the fracture is also a lot of clicking and movement there as well ,i am full weight bearing,the last X-ray was done at 4 weeks and there was no sign of any union.Has anybody had these problems. i don't know whether to rest or carry on.
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replied February 8th, 2016
Zackm whatever happened, are you healed? I'm on my 3rd bone graft. My last one I had a fibula graft and they thought I was healing and then in Dec I broke my femur again from it actually not being fully healed. I have so much missing bone they had to pack more bone from my hip in there. I'm six weeks post op and have been using a bone stimulator for the past three weeks. My accident t was in July of 2013 and it's now Feb 2016. Yes I want my life back. I have been on crutches for the past three winters and it's no fun.
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replied May 13th, 2016
Oh wow I myself have been through 4 surgery's now the next one will be the graft for my non union left femur my right leg healed just fine. It's been over 6 years since my accident.
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replied June 8th, 2017
Cliffman,
So I broke both femurs in aug 2014. Both are non union and it's been almost 3 years. The dr wants to do bone grafting for both femurs this summer from my hip and I'm nervous and terrified it will only put me in more pain/cause damage to my hips as well as my broken femurs... right now I am weight barring on both legs and can't live like I used to ovbsly but I can do a couple things during the day like go to the grocery store ext depending on the day. I'm always in pain, I just don't want more... Have you done your bone graft surgery yet for your left leg? Did it help you?? I know it's different for everyone.. I'm just looking for some comfort here I guess. I know I should get it done.. I'm just having the hardest time coming to terms with another surgery... it's been a rough couple years...
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replied December 7th, 2016
post femur bone grafting.
After your bone graft, how was the donor site( iliac crest or pelvis)? I've heard/read that it's more painful compare the fracture site.
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replied April 16th, 2018
I had a femoral osteopathy back in January 2017 to correct a historic leg length difference. 15 months later I have a non-union and am now being persecribed exogen. Desperately unhappy I sought a second opinion. Apparently there is no chance of a union without intervention and I now need the pin replaced and a bone graft from my pelvis. I am desperately unhappy at have very little quality of life (I am a young women with a young family) and I am scared to have more surgery in case I’m left in a worse condition. I have lost faith in the medical profession but desperately want to get better. I am Leong confidence as a person and dont want to be seen limping around in such a bad state. Has anyone had the above procedure? Did exogen work? How quickly after the bone graft did you notice any benefit? I desperately need hope. X
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