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Femur Break in para

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    #16
    Thanks for all the input everyone.
    My GP recommended someone in Delaware but didn't have great confidence that they would have the background that I needed, so I took some of your suggestions and contacted Univ of Md Rehab and Osteopathic Center. They advertise SCI specialties and Rehab.
    When I told them that the break was still not stabilized 12 days along and leg was swollen, they were able to schedule an appt 5 days from now with one of their Dr's. (still not sure what his specialization, but i figured just getting into the close system has to be better than what I've been doing)

    I'm looking forward to talking to someone who can speak with experience and knowledge of my unique (?) injury. Will let everyone know how this works out and whether it's worth the 3 hour journey to the center of Baltimore. (I'm not fond of driving in center cities.)

    Thx again for the input, I was at a total loss without it.

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      #17
      I'm a paragraph, and have fractured both femurs, a decade apart. Possibly because I've been SCI a long time, and have osteoporosis below my T5 level, orthopedic docs declined to use rods, etc both times. I still have an "unjoined" fracture in the most recent break, about 4 yes ago. I was hospitalized the second time, for at least a couple of weeks, monitored for dvt, etc, and the leg kept imobilized. You do need to watch out for contractures of the knee, but perhaps the rods will prevent that, not sure. I really don't have any lasting effects, aside from slight contractures in both knees. Best of luck and take to heart the excellent advice you've gotten here. Best thing you can do is become an expert on your SCI, and assume most general practitioners are not. Great u were able to get into a rehab specialty.

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        #18
        FYI, I'm not a paragraph. I'm a paraplegic. ��

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          #19
          I haven't broken my femur but I did break my hip in 2012 and when they xrayed thebreak less than 12 hours after they had screwed it back together the screws were already loose and backing out because of my osteoporosis, and that was only a year and 9 months after my sci. If you snapped your bone that easily I would be very concerned that any screws would work very well.

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            #20
            Your hip is part of your femur.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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              #21
              Well, had a visit with an Ortho Surgeon at the U of Maryland Shock Trauma clinic. x-rayed both legs, and rebandaged with splints the tibia break. Found a stage 4 pressure sore on the heel of that foot from previous bandaging.

              The Femur he simply took off the ace bandage that had been on it and said it wasn't doing anything anyway. When I asked about something to control the flop of the knee, and he said that just wait till it heals. I asked about it healing crooked and effecting by sitting with the foot and causing pressure sores, and he said it probably would heal crooked. Then he can just re-break it and go from there. In the mean time both breaks are displaced now and I'm just sent home to do the best I can for myself. Getting on and off the commode and managing clothes is really challenging with the one leg swinging freely from the broken femur, plus the breaks seem to be getting worse with being home and trying to manage for myself. I really have a bad feeling about the damage the ends can do inside my knee moving around like that as I take care of myself at home (I live on my own)

              Am very discouraged about this whole thing. Any suggestions about what questions I should be asking to get the answers I need? Obviously I'm not making myself clear, or they give me a lot more credit for being able to take care of myself with the added complications.

              A friend who works with rehab-pediatrics at Kennedy-Kreeger said that it didn't sound right to her either. She insisted I go to John's Hopkins ER and explain how this non-stabilization and all is causing pressure sores and lowering my independence and functioning level. Sounds a bit desperate to me, but I'm starting to get desperate. Still haven't been able to find a Physiatrist with SCI specialty to speak with. I keep trying

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                #22
                For whatever it’s worth, I also live alone and it was an absolute battle to get reasonable care - the ER staff couldn’t understand why a paralyzed person wanted something done about my two displaced fractures (“it’s not like you use your legs anyway, so why are you so worried about this?” PA asked), why I didn’t think a plaster cast from a PA without correcting the displacement wasn’t a good idea - basically we all knew they were broken 40 minutes after I got there and the next 14 hours I was in the ER was me asking them to explain why a large academic medical center was choosing not to provide the standard of care to an insured person with multiple broken bones who was asking for treatment. I was not nice and I was the opposite of trusting and eventually the ortho showed up with an actual plan and basically said never come here again, they’re incompetent.

                I think being discouraged is appropriate. I would also be frightened and angry.

                So. That said, if I were you I would probably go to the JH ER and explain - multiple displaced fractures, stage 4 pressure sore, SCI, live alone - that the situation is untenable. They need to help you figure something out, because this is not at all okay. Will your friend go with you? Or is there someone who can go with you and help with communication? IME, doctors don’t necessarily think about how a person will cope at home - I know my ortho didn’t, and it was his PA who took on figuring out what we could do with me until I could transfer on my own again.

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                  #23
                  Sorry for what you're having to go through. It would have taken a few clicks on the Electronic Medical Record for the surgeon to refer you to a PM&R SCI physician. If you have a Doctor who can call on your behalf, it may speed up the process. If not, call these clinics every day and ask of they have any cancellations on the schedule.

                  I don't know any of these Doctors but here's a few links and phone numbers to SCI providers in Maryland to check out.

                  https://www.kennedykrieger.org/patie...injury/ourteam

                  https://www.kennedykrieger.org/patie...ke-appointment

                  https://docfind.umms.org/UMRehab/det...es=61417&tab=4

                  https://docfind.umms.org/UMRehab/det...es=61417&tab=4

                  https://docfind.umms.org/UMRehab/det...es=61417&tab=4

                  If you're closer to Delaware, you might want to make a trip to Philly-- http://mageerehab.org/about-us/find-a-doctor/
                  Last edited by 2drwhofans; 30 Jan 2018, 7:47 PM.

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                    #24
                    Susqu, the second time I fractured my femur, I had good care. The first time was similar to what you are experiencing...a negligent "you don't use your leg so why bother" attitude. In that case, I pretty much had a shouting match with the arrogant ans disrespectful PA I saw. Didn't particularly help, but at least I stood up for myself. Your situation does not sound good, letting your knee/leg flop around sounds dangerous. How can it ever heal that way? Both times I ended up with an orthotic boot, but I had to stay in bed with the leg immobilized for 2 or 3 weeks prior to getting up using the boot. You may need to be in a transitional care facility to allow your leg to be immobilized for that time. IMO, going to the JH ER may be your only option, unless you opt to see another, more knowledgeable ortho doc. I'm so sorry you are having to deal with this runaround, on top of having a broken leg. It sucks.

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                      #25
                      My femur broke at the neck in 2005. They didn't want to do anything. They said the surgery was not the problem. But being able to heal properly from the surgery was more risky than doing nothing at all. To this day, the femur is floating. They say scar tissue will form around it as a pseudo-joint.

                      This thread has me rethinking is it work having the surgery? I have yet to find a doctor who said yes let's do it.

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                        #26
                        For me, the surgery (they did an open reduction internal fixation) worked well. There was a lot of startlement about how it was healing better than expected/predicted.

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                          #27
                          For me it would have been a hip replacement, which is probably more complicated for healing.

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