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Old 02-19-2008, 05:26 AM   #1
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Miv2332 HB User
Exclamation Femoral Intramedullary Rod Removal?

Hi,

I broke my femur right in the middle of the bone about 2 years ago. It was surgically fixed with an Intramedullary Rod/Nail and screws below and above the fracture site. It has healed very well in the past 2 years, but it definitely isn't 100%. I still have pain in the knee and hip area. I want to have the rod removed as soon as possible and start rehab/physical therapy to attain my goal of joining the US Air Force. The AF will not allow me to join with any kind of metal in my body (screws, rod) so the removal is a must.

Has anyone gone through this before? How long can I expect to be stuck in bed or on crutches? How long before I can start running and bearing all my weight on it and carrying things? My job involves carrying significantly heavy loads and I don't want my femur to snap in half again the first time I pick something up. When can I expect to be back at work?

Anything that anyone can tell me about this would be very much apprecaited, thank you very much.

 
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Old 02-20-2008, 05:40 AM   #2
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Re: Femoral Intramedullary Rod Removal?

What does your orthopedic surgeon say? It might be a good idea to get his/her opinion first to see if this is even feasible.

Be prepared that the USAF may still medically DQ you based on the injury and not just the hardware. Would I be correct in assuming that you have already talked to a recruiter?

Last edited by dustoffkid; 02-20-2008 at 05:41 AM.

 
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Old 02-20-2008, 07:02 AM   #3
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Re: Femoral Intramedullary Rod Removal?

My surgeon has said it's quite common for people to have this kind of hardware removed, but since he's never experienced it personally it's hard for him to explain to me the exact way things will go after removal. I'm wondering how long it's going to take me until I can run again without the fear of my leg just snapping in half. Also, how long it's going to be before I can get back to work and lift heavy loads without fear of re-injury.

I have spoken with a recruiter and it's a process but it's very possible for me to be able to enlist, but not until all the hardware is out.

 
Old 02-25-2008, 09:35 AM   #4
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Re: Femoral Intramedullary Rod Removal?

Has anyone gone through this?

 
Old 02-25-2008, 03:00 PM   #5
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Smile Re: Femoral Intramedullary Rod Removal?

Quote:
Originally Posted by Miv2332 View Post
Has anyone gone through this?
Over 30 years ago, I had a compound fracture of the femur. Both sides of the break was sticking out of the leg. This was repaired using a rod, and the two peices of bone twisted opposite so the rod was replaced with a plate and screws.

After two years, from an x-ray, the bone was considered to be healed and the plate and screws were removed. A couple of months additional healing time was needed for the screw holes to fill with bone and plate removal to completely heal solid. The nerves take a year or longer to heal.

Healed bone is usually considered to be more dense and stronger than before. An x-ray should confirm whether you have solid bone. I understand the fear of the bone snapping. After a year in casts of different lengths, I had that fear. Unless the bone did not heal (determined by x-ray), or you already had have a bone density problem that caused the original break, bone is strong and resilient and is not going to snap.

I would think that why the bone was broken is the main issue. My compound fracture was due to impact by a truck which would break any bone.

 
Old 02-25-2008, 05:50 PM   #6
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Re: Femoral Intramedullary Rod Removal?

I have a very unusual story, so just want to emphasize first that this is RARE. When I was 14, I had a fracture of my distal right femur (about two inches above the knee)...long story how it broke, but it was sports-related. Anyway, it was fixed with an IM rod and several screws.

At age 20, I decided to get the rod removed, because it was too long for my leg, and was prominent (poking into soft tissue in the hip--very painful!) Anyway, while trying to remove the rod, the surgeon found out that it was FUSED to my bone!! He couldn't get it out b/c it was stuck...and in the process, he hit me so hard that he broke my hip (the femoral neck area--a very serious injury that often necessitates total hip replacement!) Luckily, they were able to repair the hip with screws and I didn't need to have the joint replaced. BUT, the IM rod remained in my leg and continued to cause me pain!

At age 25, I couldn't take it anymore...I finally ended up being referred to a world-famous orthopedic surgeon in NYC, where I lived at that time. He attempted removal again, but still couldn't get the rod out. Finally, they did another surgery (my 6th surgery total)...and they had to break the femur AGAIN in order to remove the painful rod! After all that, they finally managed to remove it...and replaced it w/a new rod to repair the new fracture. But this rod is properly sized for my leg...and doesn't cause pain. However, I do have chronic pain in my hip and knee after all the surgeries and trauma.

ANYWAY...it turns out that I had a poorly designed/defective rod placed in the original fracture...it was only on the market for 6 months, back in 1993-1994. And, I had very dense bone that grew into the holes in the rod (this design had holes all over it--not a good idea!)

So this is probably the worst possible scenario anyone could have with hardware removal! Thing is, it's SO rare. I did have some hip screws removed once with no problem. Generally, when you have hardware removed and there are no complications...you should be back on your feet within two to three weeks, max. It's a good idea, however, to NOT do any activities that are too strenuous--i.e. running or any sports...heavy weightlifting, aerobics, etc. for at least 6 weeks, maybe longer...ask your surgeon about that!!! You will be sore, but it shouldn't be severe pain...the worst should be over in a week. This is probably how your situation will be, most likely!!! I wish you the best of luck! Sorry for the scare story--again, it's so rare, but I do want people to be aware that sometimes there ARE complications. Please let us know how things go; I'm sure you will be fine.

Meg

 
Old 02-25-2008, 06:29 PM   #7
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Re: Femoral Intramedullary Rod Removal?

Back in the dark ages of the early sixties My femur was broken just above the knee in a military hospital. At the time I was placed in traction for three months followed three months in a spica cast from my toes to just under my arm. No nails or rods were used. After three months in the cast it didn't heal completely and the leg was rebroken when I was removed from the cast. As a result I was placed back into the cast for another three months , After being removed I was still confined to bed and tring to exercise the leg, but it rebroke again.

It was decided then that I would have an open reduction and a bone graft around the break to stimulate calous growth around the break with the insertion of the Kuntchner nail (rod). There were no screw place in it, but the rode measurement was two inches too long, but nothing was said about the pain.

I was discharged on disability. (a lot more injuries were involved) and had to go to the VA hospital for rehab. I had the rod in for 18 months when the VA doctor was made aware of the extra two inches of the rod sticking out of the end of the femur, and he removed it without any difficulty and I was walking with the aid of a cane for a while.

Since the bone graft was close to me knee joint and a year in bed without moving the leg I had atrophy in the quads and could not bend the leg. Over time I could bend it about 34 degrees, but then I began having pain in the knee and it was just recently replaced. I still don't have full motion of the knee due to the atrophy.

Removing the rod was simple. I was given a spinal and it was easily removed and I used crutches for a couple of weeks to insure the break was properly healed.

Being bed ridden for a year caused numerous problems the most serious being osteoperosis of all my bones. It took years of excercis to get back to the point my bones were no long so fragile.

Good luck getting in the Air Force. Things have changed for the better since the Vietnam era. Doctors are a little more educated in modern medicine. I might mention I came down with pneumonia and a staph infection and was given my last rites on three occasions. I hope you have better luck than I did. I was on flight crew most all the time I was in the AF. Some was fun some not.

Dewdo from the other Washington

Last edited by moderator2; 02-25-2008 at 07:18 PM. Reason: inappropriate language

 
Old 02-27-2008, 07:30 AM   #8
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Re: Femoral Intramedullary Rod Removal?

Wow, thanks very much for the posts.. Some of these rod removal stories sound horrific.. I really do want to get it done, I hope I don't run into any problems and I am able to at least get back on my feet to start working out and building muscle again after a month or so.

 
Old 02-27-2008, 10:08 PM   #9
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Re: Femoral Intramedullary Rod Removal?

Most hardware removals are pretty routine, as I said before...my situation was indeed horrific, but it is very rare. You will most likely be fine...just don't exert yourself too much after the surgery...the bone will still be vulnerable for a while. Good luck!

 
Old 03-13-2008, 08:14 AM   #10
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Re: Femoral Intramedullary Rod Removal?

Hope this post will help.
Had the rod put in for bone tumor in 1994 (age 25). Had it removed 8 months later because it was pushing into my knee as the bone grew back pushing it into the knee.
The surgery was simple, overnight stay, and was walking with crutches the next day. Much faster recovery than the rod insertion surgery. I breezed through the PT and was back playing volleyball that summer.
So, I had it in and out in under a year and did great. I think the young age helped too. Only problem with mine is that apparently when the surgeon removed the bone - he pulled out some of the good bone; so it required more time for the bone to fill back in with good bone.
But in regards to a break. The bone grows back more around a break. It is very unusual for a bone to break in the same spot. Typically it would be on either side of the healed bone.
Here's wishing you the best!

 
Old 03-19-2008, 06:11 PM   #11
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Re: Femoral Intramedullary Rod Removal?

Everyone's replies have been very helpful. I forgot to ask this in the original question, but did any of you have to have your leg in a cast or a brace after the removal? I didn't have a cast at all when it was inserted, just a full leg brace that could be set to flex to different angles at the knee. I am curious as to whether or not the entire leg will have to be casted. The doctor has said I'll have to be off my feet for a little while to heal up while the holes where the screws were fill in, but neglected to say whether i'll be in a cast.

Hrtofluv, how many months after the surgery were you back to volleyball? My job involves heavy lifting and I'm looking forward to sports this summer (non-contact) and I was wondering if I'll miss out on all that and have to miss work for a few months. How many weeks/months until you were comfortable playing ball or doing any kind of heavy lifting? Anyone else that could chime in would of course be welcome very much, thanks!

 
Old 03-19-2008, 08:36 PM   #12
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Re: Femoral Intramedullary Rod Removal?

Miv,

If all goes well, which it should, then I don't see why you would need a cast or brace. The doctor is right; you do need to be careful while the bone is filling in the holes...you should be able to walk without crutches fairly soon, as early as one week possibly, but I don't think any later than two weeks. Still, don't overdo it...you really should ask the doctor about heavy lifting; I don't know much about that. As for sports, I really would wait a good six weeks, just to be on the safe side. You will definitely be ready for summer sports if you get this done soon

 
Old 03-24-2008, 07:48 AM   #13
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Re: Femoral Intramedullary Rod Removal?

I doubt you would need a cast or a brace. Crutches for the first week or so and lots of rest to ensure the screw holes fill in with good bone. No PT needed for the removal either. As for me - surgery in mid-March (just about now) and was playing sand volleyball in early June. Didn't move to court until the fall, but I was definately okay by then. The first fall on my behind still sent little shocks and everyone surrounded me, but I was fine after a few minutes. Heavy lifting would be a different story though - you are adding more weight to the leg. Asking the doc would be best.
Good luck!

 
Old 04-09-2008, 05:32 PM   #14
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Re: Femoral Intramedullary Rod Removal?

I'm hoping you can answer a question. I just had a femoral rod surgery 3 weeks ago for a bone tumor. My doctor said I could bear weight on it after a short while. Well, I still can't walk without my walker and any sudden jolt or twist sends a sharp pain from my groin area down to below my knee. Although I'm a little older, I was very active before this surgery. How long did it take you to go "solo" with walking again AND did you do any physical therapy? Thank you for your time.

Last edited by judy8799; 04-09-2008 at 05:35 PM.

 
Old 04-11-2008, 10:45 AM   #15
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Re: Femoral Intramedullary Rod Removal?

Hey Judy - sorry you had to go through this surgery too. The initial surgery recovery time was 2-3 months with PT. I started with a walker, then worked up to a cane, but it took time. I was also 24 when it happened, so if you have other conditions (such as arthritis or old injuries) - it may take longer.
I would really push for PT from your doctor. To get the rod in place - they have to separate all your leg muscles which means they all have to remember what they used to do. Sometimes it just takes longer, but PT will help with getting your total range of motion back.
Wishing you all the best!

 
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