Healing time depends on many factors, such as the blood supply to the bone, the amount of muscle and tissue near the bone, how badly it was broken, a patient’s age, and general health. Sometimes things you might not think matter will affect the bone healing, like smoking or diabetes. Most fractures require 8 to 12 weeks to heal to the point where they can be walked on. Some areas of bone heal more slowly. This is usually due to poor blood supply to these areas. Slower healing areas include: some bones in your wrist and foot, and the tibia (shin bone).
The best place to get your wound evaluated is in your orthopaedic surgeon's office. If they are not available, you can go to your local emergency room or primary care doctor for evaluation. They may be able to contact your doctor or another surgeon who can assist you. Always notify your treating surgeons of wound or surgical site concerns. Antibiotics may help fight the infection. Sometimes, after the antibiotics are stopped, the infection comes back. Whenever you can, keep track of the names of antibiotics you’ve taken, for how long, and if possible, your culture results.
The best place to get evaluated is in your orthopaedic surgeon's office. If this process does not provide sufficient guidance, you can go to your local emergency room for evaluation. The emergency room may be able to contact your doctor or another surgeon who can assist you. Some fractures heal more slowly than others. It does not mean that your care was wrong or inappropriate. Sometimes it is hard to assess healing with x-rays, so the surgeon will need to conduct a clinical examination as well. You can ask your surgeon how your fracture is healing. If it is healing slowly, ask if there is anything you can do to help the healing process. Some things that may help include adjusting your diet or your vitamin levels, or addressing other medical issues you may have. Sometimes there is a need for another surgery to place a bone graft at the fracture site. This is common in high energy injuries and fracture of your long bones. It is also seen in some medical conditions and smokers.
Broken bones are often repaired by an orthopaedic surgeon and held in place with hardware such as screws and metal plates. In that case, a cast, splint, or brace maybe used to protect the wound, or to let the soft tissue "rest" for several weeks. Some fractures are only treated with a cast, which needs to stay on until the bone is healed enough so that the cast is no longer needed. The length of time you’re in a cast or a boot is injury- and patient-specific, and the best estimate will come from your doctor.
These should not be removed by you unless instructed by your doctor. In general, a cast or splint should not to be removed by anyone other than your surgeon. It is important to not cut them off yourself, as you may hurt yourself or make your injury worse. Also, do not stick things down your cast or splint. Trying to scratch an itch may damage your skin and lead to an infection or other issues with your wound. If your splint or cast is bothering you, call your surgeon as soon as possible. Sometimes, boots, splints, or braces can be removed for physical therapy, motion activities, sleeping, or bathing. You should ask your surgeon if this is okay.
Almost every surgical patient has two injuries. The first is from the event that caused the injury. The second is from the surgery to correct the first injury. Swelling is a natural part of the injury and healing process, and it develops much faster than it goes away. Swelling around the feet and ankles often takes months to go away, since gravity pulls fluid downhill to the legs. Sometimes it never completely goes away. Even a simple fracture is not just an injury to the bone; the soft tissue around the bone is also injured. The healing of fluid channels in your injured limb involves waiting for soft tissue repair and the return of pathways through which that fluid normally returns to the heart. If you have swelling in both of your legs, it could be from other medical issues. If you have any concerns, contact your primary care doctor.
Every injury causes bleeding. As your body breaks down the blood at the site of the injury, it turns various colors. Essentially, it's a bruise that may take months to fully resolve. Gravity may cause these color changes to track down the arm and the leg all the way to the toes or fingertips, even if the injury was at the shoulder or the hip.
It can be tough to sleep after an injury due to pain (especially at night when there are no other distractions) or because you cannot stop thinking about your injury. Some helpful tips to improve your sleep include:
- Set a routine for getting into bed and waking up, and stick to it through the week.
- If you cannot sleep, get up and out of bed after about 20 minutes and do not go back until you think you can fall asleep. Do not nap during the day.
- Ice or heat can reduce your pain. Ice helps in the immediate time after surgery.
- Limit stimulants, like caffeine and alcohol.
- At bedtime, avoid stimulating light sources like TV, computer screens, or your phone.
Sleep medications are not always the answer. They make it hard to wake up and can have unwanted side effects. These should be discussed with your primary care physician. Some medical conditions like sleep apnea can affect your sleep as well. Narcotics are not the answer to sleep disturbance and can cause issues with sleep. You should discuss your sleep concerns with your surgeon as well as your primary care physician.
Typically, your incisions and wounds need to heal before activity is started. Injuries, splints, and casts can all cause stiffness. Sometimes therapy is needed to show you how to use crutches or other devices and to restore motion before your bones are fully healed. Therapy is sometimes used to help teach you how to move around and/or do everyday activities. Discuss this with your doctor. Always consult your doctors before engaging in any work or exercise activities.
This depends on the type of work you do and your specific injuries. Jobs in which you have to be on your feet, able to lift, or perform repetitive activities usually require complete bone healing and getting your full strength and range of motion back. You may be able to return to a desk type job or work from home sooner. Please talk to your treating surgeon about your specific job to determine your limitations, when you can return to work, and in what capacity.
The question of when is it "safe" to operate a car is a complicated issue and varies with the patient. Below is some general information that can serve as a very rough guideline. Please remember that it is always best to discuss this issue with your doctor.
Reaction time, decision making, the ability to move the steering wheel and push the peddles are a few of the factors that determine the ability to safely drive. You must not be taking any narcotics (opioids) or other medications that may alter your reaction time. Some medications cause sleepiness and impaired decision making, and cannot be combined with driving. You must be able to bear weight on your leg to use a foot pedal. Casts, splints, or braces can prevent safe driving by limiting movement. In most states it is illegal to drive if you have a cast on your foot or ankle. Pain with moving the arm or leg may also limit your ability to respond. If you cannot respond quickly enough due any of these factors, it is not safe to drive. It may take months to recover adequately. Some studies show that even if you feel normal, your reaction time might be affected enough to prevent you from driving safely. If you get into an accident and your injury is believed to have limited your movement, reaction time, or decision making, the authorities may say you couldn't respond to the road appropriately and it's your fault.
Your surgeon's office can help you with this. Do your best to make it easier for your doctor and office staff to complete your paperwork. One option is to photocopy everything and fill out as much as you can on one copy and give both the partially completed and blank copy to the office staff. Don't expect the paperwork the same day as your appointment. Offer to come back, or ask to have the paperwork mailed, emailed, or faxed to wherever it needs to go. Due to the overwhelming demands of filling out paperwork for their many patients, some doctor's offices charge a fee for this helpful service.
You may or you may not, depending on the sensitivity of the detector. You can tell security you have metal in you before going through the detectors. They may ask to see your scars or do a more extensive search regardless of what you tell them. There is nothing your surgeon can give you to go through security more easily. Lots of people have knee and hip replacements and still travel without issue. Hardware from trauma is not very different from a total knee or a hip replacement.
An orthopaedic trauma surgeon has training in muscle and bone injuries that result from trauma. Traumatic injuries can happen in many ways, including motor vehicle and motorcycle collisions, falls, weapon injuries, industrial accidents, etc. Orthopaedic trauma surgeons tend to have more training for treating injuries to the pelvis and hip joint than other orthopaedic specialties.
Don't confuse a general surgery trauma surgeon with an orthopaedic trauma surgeon. General surgeons typically operate on internal organs such as the stomach, kidneys, or bowel. If you had a major trauma, you may be seen and treated by both types of surgeons.