Patient: On March 31, 2009, he fell from a height and fractured his femoral head. Two days later, he was operated on and treated for 10 days at Chengde Affiliated Hospital, and first recuperated at home.
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: From the X-ray film, we can see that the fracture alignment is OK, the fracture line is still clear, the nail tail is downwardly displaced, and no obvious abnormal signal is seen in the femoral head. If there is no obvious local discomfort. Continue to move under protection and do not put weight on. Take medication to promote fracture healing. MRI and X-ray examination can be done in about six months, preferably with lateral films.
Patient: Thank you, Dr. Tang, for your reply in your busy schedule. How long does it usually take to recover from this condition, and how much does it cause femoral head necrosis? Some doctors suggest functional hip exercises, but I don’t know what functional hip exercises are. If so, how should I do it?
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: The chance of femoral head necrosis in femoral neck fracture is between 30-60%, and most of them occur six months to two years after surgery. Early X-ray is difficult to detect necrosis, MRI is a more sensitive method. It is recommended that MRI examination can be done in 9 months after surgery to understand whether there is femoral head necrosis. Now you can move around in bed, no weight-bearing. Mainly exercise the muscles of the hip and thigh, and the function of the hip joint. This can promote fracture healing, prevent muscle atrophy and help to prevent femoral head necrosis.
Patient: Thank you again for your busy reply, is the hip function exercise to exercise the range of motion of the hip? For example, leg lifts and extensions?
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Yes, the amount of activity should be appropriate. It is best to do it with a specialist.
Patient: Yes, thank you very much, Dr. Tang for your busy reply!
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Wish you a speedy recovery!
Patient: Thank you, Dr. Tang.
The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Department of Orthopedics, Tang Liming: No need
Patient: Hello, Dr. Tang: I had another X-ray last Friday, can you please help me see how the healing is going? How can I proceed with the next step of rehabilitation exercises? Do I still need to take medication? (I am now moving around with my main crutches, and I am not bearing weight as you suggested)
Tang Liming, Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: The X-ray film on July 7 showed a blurred fracture line with bone scab formation, and no displacement change compared with the previous X-ray film. It should be said that the condition is recovering, but I hope you follow the advice given to you to deal with it.
Patient: Thank you, Dr. Tang. May I ask Dr. Tang, about how long can I practice weight bearing?
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: It is best to start after six months, and after a year of full weight bearing. After MRI examination, you can decide.
Patient: Yes, thank you, Dr. Tang!
Patient: Hello Dr. Tang: It has been 4 months since my injury, and now I have no pain in the injured area, but I found that the injured leg has become significantly thinner, is this muscle atrophy? Why would this happen? (Now walking on crutches, no weight bearing)
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: There is no relationship, muscle atrophy is caused by long-term non-weight-bearing, and it can recover later.
Patient: Oh, then I am relieved, thank you Dr. Tang!
Patient: Hello Dr. Tang, I have been injured for half a year, can I take a film to check the recovery situation? Some doctors say it is better not to take the film too often, it will affect the recovery, may I ask how much will one film affect? Thank you for your reply.
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: You can take a film six months after surgery, how much it will affect your body
Patient: Yes thank you!
Tang Liming, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: No need