HomeAnswersOrthopedician and TraumatologyfracturesHow long will it take for a femur shaft fracture to heal?

What is the prognosis of a proximal femoral shaft fracture?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Anuj Gupta

Medically reviewed by

iCliniq medical review team

Published At September 19, 2022
Reviewed AtJanuary 19, 2024

Patient's Query

Hello doctor,

I am a 65-year-old female who suffered from a proximal femur shaft fracture and residual gaps. I have been walking perfectly after ORIF, done one year back, and physiotherapy after four months. However, just in the last routine review and X-ray, I was diagnosed with 70 % union and 30 % nonunion fracture and was suggested dynamization by removal of the distal locking screw. This procedure was done last month. And I was advised to use a walker as a precaution for one month. Now I am concerned about whether this line of treatment and progress is fine and whether a complete union is possible in a fracture-prone femur because of a fall by a stumbling block.

Kindly help.

Answered by Dr. Anuj Gupta

Hello,

Welcome to icliniq.com.

Thank you for your query. Only a single X-ray will not help. Please share the previous X-rays for comparison.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

ORIF for proximal femur fracture was done last year, and I have an X-ray which I am attaching below. Titanium rod or nail and screws were used (two proximal and one distal screw). The dynamization process was done last week by removal of the distal screw, and it was confirmed through laboratory tests that there was no infection affecting healing progress. My doctor felt it could be because the fixing was so rigid, residual gaps continued, and dynamization was being tried to fasten the healing process. I am otherwise perfectly alright. I had traveled before this distal screw removal by air and felt no discomfort externally, so I stopped using a walker and stick after four months. So I want a second opinion about this line of treatment.

Kindly help.

Answered by Dr. Anuj Gupta

Hello,

Welcome back to icliniq.com.

Thank you for your query. In the X-ray (attachment removed to protect the patient's identity), the bone is not united, which is something to worry about. Though you were walking comfortably, it was putting a lot of stress on the nail. Therefore there are possibilities of nail breakage with dynamization. Usually, we remove one screw and allow the fracture area to collapse when we bear weight on that limb. Because of collapse, there will be increased contact between fracture ends, and the bone will unite. I feel whatever your surgeon has done is the best anyone can do. I hope this has helped you.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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