ORIF - femur - discharge; Open reduction internal fixation - femur - discharge
When You Were in the Hospital
You had a fracture (break) in the femur, also called the thigh bone, in your leg. You may have needed surgery to repair the bone. You may have had surgery called an open reduction internal fixation. In this surgery, your surgeon will make a cut to open your fracture.
Your surgeon will then use special metal devices to hold your bones in place while they heal. These devices are called internal fixators. The complete name of this surgery is open reduction and internal fixation (ORIF).
In the most common surgery to repair a femur fracture, the surgeon inserts a rod or large nail into the center of the bone. This rod helps support the bone until it heals. The surgeon may also put a plate next to your bone that is attached by screws to a frame outside your leg.
What to Expect at Home
Recovery usually takes 4 to 6 months. The length of your recovery will depend on how severe your fracture is, whether you have skin wounds, and how severe they are. Recovery also depends on whether your nerves and blood vessels were injured, and what treatment you had.
Most of the time, the rods and plates used to help the bone heal will not need to be removed in a later surgery.
You may start showering again about 5 to 7 days after your surgery. Ask your doctor or nurse when you can start.
Take special care when showering. Follow your doctor’s instructions closely.
- If you are wearing a leg brace or immobilizer, cover it with plastic to keep it dry while you shower.
- If you are not wearing a leg brace or immobilizer, carefully wash your incision with soap and water. Gently pat it dry. Do not rub the incision or put creams or lotions on it.
- Sit on a shower stool to avoid falling while showering.
Do not soak in a bathtub, swimming pool, or hot tub until your doctor says it is okay.
Change your dressing (bandage) over your incision every day. Gently wash the wound with soap and water and pat it dry.
Check your incision for any signs of infection at least once a day. These signs include more redness, more drainage, or the wound is opening up.
Tell all of your health care providers, including your dentist, that you have a rod or pin in your leg. You will probably need to take antibiotics before dental work and other medical procedures to reduce your risk of getting an infection. You will need to do this for as long as you have the metal hardware in your body.
Have a bed that is low enough so that your feet touch the floor when you sit on the edge of the bed.
Keep tripping hazards out of your home.
- Learn how to prevent falls. Remove loose wires or cords from areas you walk through to get from one room to another. Remove loose throw rugs. Do not keep small pets in your home. Fix any uneven flooring in doorways. Have good lighting.
Make your bathroom safe. Put hand rails in the bathtub or shower and next to the toilet. Place a slip-proof mat in the bathtub or shower.
- Do not carry anything when you are walking around. You may need your hands to help you balance
Put things where they are easy to reach.
Set up your home so that you do not have to climb steps. Some tips are:
- Set up a bed or use a bedroom on the first floor.
- Have a bathroom or a portable commode on the same floor where you spend most of your day.
If you do not have someone to help you at home for the first 1 to 2 weeks, ask your doctor or nurse about having a trained caregiver come to your home to help you. This person can check the safety of your home and help you with your daily activities.
Follow the instructions your doctor or physical therapist gave you about when you can start putting weight on your leg. You may not be able to all, some, or any weight on your leg for a while. Make sure you know the correct way to use a cane, crutches, or walker.
Be sure to do the exercises you were taught to help build strength and flexibility as you recover.
Be careful not to stay in same position for too long. Change your position at least once an hour.
When to Call the Doctor
Call your doctor if you have:
- Shortness of breath or chest pain when you breathe
- Frequent urination or burning when you urinate
- Redness or increasing pain around your incision
- Drainage from your incision
- Swelling in one of your legs (it will be red and warmer than the other leg)
- Pain in your calf
- Fever higher than 101°F
- Pain that is not controlled by your pain medicines
- Nosebleeds or blood in your urine or stools, if you are taking blood thinners
Rudloff MI. Fractures of the lower extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 55.
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