ORIF - femur - discharge; Open reduction internal fixation - femur - discharge

You had a fracture (break) in the femur in your leg. It is also called the thigh bone. 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 made a cut in the skin to align your broken bone.

Your surgeon then used 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. Sometimes, fixation devices are attached to a frame outside your leg.

Recovery most often 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 be able to start showering again about 5 to 7 days after your surgery. Ask your health care provider when you can start.

Take special care when showering. Follow your provider'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 when your provider says this is OK. 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 provider says it is OK.

Change your dressing (bandage) over your incision when instructed. 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 providers, including your dentist, that you have a rod or pin in your leg. You may need to take antibiotics before dental work and other medical procedures to reduce your risk of getting an infection. This is more often needed early after the surgery.

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 safer. 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 provider 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 provider or physical therapist gave you about when you can start putting weight on your leg. You may not be able to put 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.

Contact your provider 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 (38.3°C)
• Pain that is not controlled by your pain medicines
• Nosebleeds or blood in your urine or stools, if you are taking blood thinners
• Sudden difficulty with walking and putting weight on your leg

Kalb RL, Fowler GC. Fracture care. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 178.

Rudloff MI. Fractures of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 54.

Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 53.