Knee > Fractured Thighbone > Treatments

    Closed Reduction and Casting

Home Recovery

If your fractured thighbone is set without surgery and requires a cast, it is important that you monitor your condition and take specific precautions to protect the leg and speed recovery.

   The first concern is to monitor swelling for the first 48 hours while wearing your cast. If your swelling decreases dramatically during this time, the cast may become too loose. If swelling increases, your cast may become too tight, and circulation can be dangerously cut off. In both cases, you should contact your physician immediately.

   You will probably experience pain for the first few days after you are casted. This pain can generally be adequately controlled with the pain medication prescribed by your physician. If the pain does not gradually decrease within a few days, contact your physician.

   A rash or irritation around your cast may indicate poor fit or sensitivity to the materials in the cast. If you develop a skin irritation around your cast, contact your physician immediately.

   As with most knee injuries, treat with R.I.C.E. (rest, ice, compression, elevation). You may or may not be able to put some weight on your leg, depending on your physician's recommendation. Wrap ice into a well-sealed plastic bag and drape around the cast at knee level for 20 to 30 minutes, two or three times a day.

Patients with closed thighbone fractures typically wear a cast for four to six weeks. Because your mobility will be limited during this time, it is important that you take special precautions.

   Elevating your injured leg above heart allows gravity to help reduce swelling and fluid accumulation. Place a stack of pillows under your ankle while you are lying on your back.

   If you notice any wear or discomfort, contact your physician as early as possible. In general, do not try to "grin and bear it" if discomfort does not go away within a few days.

Straight leg raising, which exercises the thigh muscles (quadriceps), usually are recommended after one or two days. To avoid complications, only your doctor should remove the cast with a special vibrating cast saw. In most cases, the cast is removed after four to six weeks.

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Once the pain and swelling associated with a fractured thighbone have subsided, your physician may recommend physical therapy to help strengthen the muscles around your knee and improve your knee's range of motion. Though everyone's rehabilitation program is slightly different, physical therapy for a fractured thighbone follows a general pattern. Range of motion is extremely important. Movement may be painful at first, but it is important to not allow the knee to stiffen. Rehabilitation typically includes resistive exercises - those involving weights - to keep the muscles around your knee strong. You should eventually be able to resume functional activities like stair climbing, single leg support, swimming, and driving. You will be able to begin more vigorous activities as your fracture heals and your leg gets stronger.

   Knee strengthening exercises: Thighbone fracture

Once your fractured thighbone has healed, building muscle strength around your knee can help you avoid further injury. Contact sports and activities increase your chances of re-injuring your knee. Many of the exercises and activities that are popular for fitness put stress on your knees. To prevent further knee injuries it is important to learn knee-sparing exercise techniques by dividing your activities into three components:

   Daily Living - the average person takes between 12,000 and 15,000 steps a day, exerting a force between two and five times your body weight on your knees. After a knee injury, take it easy on your knees during the day whenever possible to save them for activities and exercise. Avoid stairs when there is an elevator, take the shortest path when walking, and consider wearing athletic shoes designed to absorb shock.

   Muscle Strengthening/Conditioning - activities themselves are not a substitute for conditioning. Adhere to the muscle strengthening program you learned during your rehabilitation program. The best strengthening programs are low-impact and non-weight-bearing, like stationary bikes and certain weightlifting programs, because they do not force the knees to absorb excessive shock and take stress off the knees.

   Recreation - your sport or activity of choice helps maintain mental and physical well-being, but it is not a conditioning program. Sports that require twisting and quick direction changes put great strain on your knee, increasing your chances of reinjury.

A discussion with your physician or physical therapist can help determine the appropriate exercise program and activity level for you.

PAIN

A small amount of pain is normal during physical activity, but if you feel so much pain in your knee to warrant taking pain medication before an activity, you should consider cutting back or stopping. Pain can also indicate reinjury. Do not play through the pain after a fractured thighbone - it may be a sign that your activity is putting too much stress on your knee. If you are unsure of the safety of an activity, discuss it with your physician.