[percepied]

I recently broke my left leg by accidently twisting it in an awkward way in my car. The outcome was a spiral fracture of my left femur complicated by my failure to get medical attention for 24 hours. A titanium nail with screws was placed in my leg, and I spent 2 days receiving tranfusions for internal bleeding. Next I was informed that a. pseudomonas had infected the injury site and that I will need to be on antibiotics for at least three months. I was also told that if the fracture did not heal, the nail would have to be removed to discourage the spread of the bacteria.

I have heard a number of final outcomes from medical professionals with regard to an infected fracture, anywhere from no issues to external fixation to osteomyelitis. Does anyone have experience with this situation?

[LadyPilot]

I broke my femur, just above the knee in a bad transfer into my car. I didn't hear it break but my mum who was with me, did. She made me drive to the hospital by which time my thigh was swelling nicely inside my jeans.
The hospital operated that evening, fixing an 8" plate and screw to the shattered bone. I also had a blood transfusion, ( I looked like a corpse prior to receiving the blood!) After the "Op" I was very aware of pain (but had not been before) and they put my leg on a passive excerciser (sp?) and that was great. I was in Hospital for two weeks before they released me.
I continued to feel a lot of pain and eventually they put my leg in a full length cast. I had no problems after that, and the cast was removed about three weeks later.

There was a suggestion of removing the pin and plate at a later date but I declined and almost 15 years later I still have the pin and plate 'in situ'. Occasionally I get increased pins and needles round my knee and am aware of the screw through it, but thats it. Oh I forgot, my right leg is now about an inch shorter than the left.

I am sorry that you got an infection. I cannot help you with that, I guess that I was one of the lucky ones with no issues after breaking my femur.

I really do wish you a speedy recovery with no lasting problems.....

[percepied]

Thanks for the well wishes, LP.

I'm still trying to get a handle on the infection situation. I was told by another ortho doc that there is no way that the titanium nail could remain in my leg with a pseudomonas infection. He also said an external fixator would have to be used to heal the bone -- if it ever heals! I'm extremely depressed with the situation. I don't like taking the antibiotics and I feel a PICC line and stronger antibiotics are in my future.

Can anyone else chime in? Thanks.

[smokymtn memories]

Back in 2000 I broke my ankle in three places. I did'nt bother to go to the doctor for about ten days, I just thought it was sprained. I guess I was lucky, no infection, but I did have to have surgery. I've got a plate and five screws in my right ankle.

Hope your leg heals! Good luck!

[john S.]

percepied, on Oct 19 2007, 12:01 AM, said:

Thanks for the well wishes, LP.

I'm still trying to get a handle on the infection situation. I was told by another ortho doc that there is no way that the titanium nail could remain in my leg with a pseudomonas infection. He also said an external fixator would have to be used to heal the bone -- if it ever heals! I'm extremely depressed with the situation. I don't like taking the antibiotics and I feel a PICC line and stronger antibiotics are in my future.

Can anyone else chime in? Thanks.

I've never heard of the pseudomonas and titanium having an interaction but that doesnt mean its not true. You might want to try taking some pro biotics like acidophylus and extra vitamin C. The idea being to starve the bad bacteria by uping the good bacteria till the bad stuff starves. You really want to do everything you can to keep that leg. Sure brings up how flimsey our bones get. If the bone gets infected you got a problem but the doctors trying to get you through this. If the bone dies you'll loose your leg. A gentle leg massage a few times a day wouldn't hurt.
If you have a lot of houseplants, get rid of them. Pseudomonas comes naturally from live plant leaves and soil. I like plants too. They always seem to have bugs attached.

best wishes,
john

[kewlcatkez]

john S., on Oct 29 2007, 11:34 PM, said:

percepied, on Oct 19 2007, 12:01 AM, said:

Thanks for the well wishes, LP.

I'm still trying to get a handle on the infection situation. I was told by another ortho doc that there is no way that the titanium nail could remain in my leg with a pseudomonas infection. He also said an external fixator would have to be used to heal the bone -- if it ever heals! I'm extremely depressed with the situation. I don't like taking the antibiotics and I feel a PICC line and stronger antibiotics are in my future.

Can anyone else chime in? Thanks.

I've never heard of the pseudomonas and titanium having an interaction but that doesnt mean its not true. You might want to try taking some pro biotics like acidophylus and extra vitamin C. The idea being to starve the bad bacteria by uping the good bacteria till the bad stuff starves. You really want to do everything you can to keep that leg. Sure brings up how flimsey our bones get. If the bone gets infected you got a problem but the doctors trying to get you through this. If the bone dies you'll loose your leg. A gentle leg massage a few times a day wouldn't hurt.
If you have a lot of houseplants, get rid of them. Pseudomonas comes naturally from live plant leaves and soil. I like plants too. They always seem to have bugs attached.

best wishes,
john

Hi John,

Its more that ( rarely)the pseudomonas may have been introduced by the titanium, etc. But more a case of when there is a wound infection, metalwork is often removed in an effort to heal the wound and rid it of infection quickly.
You see, infection where an implant is involved ( titanium screws etc) is very difficult to heal. Orthopaedic surgeons usually follow a protocol in an attempt to heal a wound containing metalwork/cement/and rarer ~plastics. The protocol includes removal of the material and cement and then a 6-week course of systemic antibiotic therapy before prosthesis (implant) reimplantation. This is to reduce the chances of the surface of the implant harbouring the infection as some studies have shown that this can happen with possibly some changes to its surface.

Hope this helps,

Oh and all the best to the OP, I hope that you are well on your way to recovery now,


K

This post has been edited by kewlcatkez: 30 October 2007 - 12:09 AM

[percepied]

Unfortunately pseudomonas will create a biofilm on the titanium rod and prevent bone healing. Osteomyelytis is also a possibility. Fortunately I haven't shown any symptoms of osteo and my latest x-ray (6 weeks) is showing some bone growth ... maybe? I still think the rod will have to be removed and since pseudomonas is highly resistant, I'll likely be on IV antibiotics soon. (What an optimist I am!) I'm just praying for bone growth and no osteo.

John, you are definitely right about the pro-biotics and antioxidants. I'm taking high doses of acidophylus and vitamin C. I just hope I can ward of any nasty bugs like C-diff. What a miserable experience that is!

Any more broken bone experiences?

Here's an image of the original fracture.

[rkzenrage]

Much love going your way.
I have osteoporosis, lots of little fractures and broken some of my discs, not the same thing, but yes, in a way.
I had to stop using a manual chair because it was breaking my ribs.
Hoping that you do not get an infection, lots of complications possible with fractures, best not to go into them.
Please do everything they ask you to and keep us posted.

[john S.]

percepied, on Oct 30 2007, 12:15 AM, said:

Unfortunately pseudomonas will create a biofilm on the titanium rod and prevent bone healing. Osteomyelytis is also a possibility. Fortunately I haven't shown any symptoms of osteo and my latest x-ray (6 weeks) is showing some bone growth ... maybe? I still think the rod will have to be removed and since pseudomonas is highly resistant, I'll likely be on IV antibiotics soon. (What an optimist I am!) I'm just praying for bone growth and no osteo.

John, you are definitely right about the pro-biotics and antioxidants. I'm taking high doses of acidophylus and vitamin C. I just hope I can ward of any nasty bugs like C-diff. What a miserable experience that is!

Any more broken bone experiences?

Here's an image of the original fracture.

attachment

When I broke my neck I broke a bunch of things including my skull, lower spine , 4 ribs, pelvis, left hip, left femur and right leg below the knee and right ankle. I also brok a bunch of fingers. Spleen ruptured and although I have no memory of it there weren't many bets I'd make it the first week, let alone 32 years.
My experience with healing them was tied into learning to speak better. this is a long term memory test. quads don't heal bones well. It is important to get calcium and vitamin C along with sunlight. While your doing it you need to watch your kidneys and bladder for stones forming and check for bone spurs growing where you were hoping the bone would heal. The trouble with nurses not washing has always been there. c-diff is a result of lazy medical staff using hand sanitizer. If you get some really strong sanitizer it irritates their skin and they got to wash it off. (add pure ethanol to the wall dispensor).
Did you ask your doctor if your leg might heal faster with some donor bone from a rib replacing the titanium nail? Might sound dumb but can't hurt to ask. I've heard where some bone graphs are very strong.

best wishes.
john