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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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My life just went from bad to worse. I was training for the local senior olympics and broke my leg. The problem is I have a hip and knee replacement on that side. So now I have a break between them. I'm in the hospital waiting for the surgeon to tell me what to do. I'm searching the web for any information on this type of problem. What can you tell me?

Although this type of fracture is relatively uncommon, there have been reports published so there is some information available. With more and more older adults like yourself remaining active, we expect to see this problem on the rise. By definition, what you have is an interprosthetic fracture -- a fracture of the femur below the hip joint replacement and above the knee joint replacement. Treatment is guided by a classification system that takes into account 1) whether or not the implants are broken or damaged, 2) the quality (and quantity) of bone around the implant, 3) location of the fracture, and 4) severity of the fracture. For example, some minor fractures of the bone surface can be left alone. If treatment is needed at all, a small bone graft may be done. Nonoperative care is often reserved for patients who weren't walking before the injury or who wouldn't tolerate surgery due to poor health. This certainly doesn't describe you! The surgeon will have to evaluate your X-rays and any other imaging studies ordered. The fracture site will have to be examined for severity and the presence of any displacement (separation of the bone at the fracture site). Likewise, both implants will also be assessed to determine any problems, damage, and stability. All efforts are made to save the bone and the implants. The goal will be to preserve alignment and function. Fixation with metal plates, screws, pins, and/or wires may be needed. Special locking plates and screws are now available to help span the fracture site, especially for patients with brittle bones. Your recovery will depend on any additional complications such as failure of the fracture to heal (called a nonunion), malunion, or infection. Reports suggest an average of three months for the fracture to heal and another 12 to 16 months to recover fully. "Recover fully" means to return to your previous activity level before the break. Once the surgeon meets with you, you will have a better idea what to expect. Having this information ahead of time might help you formulate whatever questions you might have for the surgeon.


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