Femur & Tibia Fracture Nailing
Intramedullary nailing for femur and tibia fractures with Dr. Steven Ward in Tucson and Oro Valley — a strong rod inside the bone that holds the fracture and lets you start moving early.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The femur is the longest and strongest bone in the body. The tibia is the most commonly broken long bone. Breaks along the long, straight middle part of either bone are called shaft fractures.
- Femur shaft fractures — usually from high-energy injuries such as car or motorcycle crashes, or from a simple fall in older adults with weak bones
- Tibia shaft fractures — from crashes, falls, or twisting sports injuries; the fibula is often broken too
- Breaks just below the hip (subtrochanteric) — also treated with a nail; see hip fracture
- Open fractures — bone through the skin, which needs antibiotics and surgical cleaning right away
Is surgery right for you?
Almost all femur shaft fractures need surgery. Tibia fractures are sometimes treated without surgery when:
- The skin is intact and the bone ends have barely moved
- A person is less active and can tolerate small differences in alignment or length
- Health problems make surgery too risky
Non-surgical care starts with a splint while swelling goes down, then a cast and later a functional brace. Surgery is recommended for open fractures, breaks in several pieces or out of position, and fractures that are not healing. Before surgery, the leg may be held in a splint or traction to keep the bones lined up.
How the surgery is done
Intramedullary nailing is the method most surgeons use for femur and tibia shaft fractures.
- A metal rod (usually titanium) is passed down the hollow center of the bone, across the fracture, through a small incision at the hip or knee end of the bone
- Screws at each end lock the nail so the bone keeps its length, alignment, and rotation while it heals
- Plates and screws are used instead when a break extends into the knee, ankle, or hip joint
- External fixation (pins and an outside frame) may hold the bone temporarily when the skin and muscles are badly injured or when there are other serious injuries
Why a nail?
A nail gives strong, stable fixation along the whole length of the bone and shares load with it. That often lets you start moving and putting weight on the leg soon after surgery.
Nails are usually left in place. If the ends of the nail or its screws irritate you once the bone has healed, they can be removed.
Recovery overview
Typical ranges only, based on AAOS OrthoInfo patient education. Open fractures, breaks in many pieces, and tobacco use can all slow healing, and Dr. Ward’s plan for you may differ.
In the hospital
- A physical therapist usually starts exercises and walking with crutches or a walker while you are still in the hospital
- Many people are allowed to put as much weight on the leg as they can tolerate right after surgery, but some fractures need limited weight at first
- Blood clot prevention as directed
First weeks to months
- Follow your weight-bearing instructions exactly
- Physical therapy restores strength, motion, and walking
- Follow-up X-rays check healing
- Tell Dr. Ward about knee pain after a femur fracture, since the knee ligaments are occasionally injured too
Months 3–6 and beyond
- Femur shaft fractures typically take 3–6 months to heal completely
- Tibia shaft fractures typically take 4–6 months
- Some take longer, especially open fractures, breaks in several pieces, and in people who use tobacco
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Toes or a foot that turn pale, blue, or cold, or numbness or tingling in the leg or foot that does not go away once the anesthesia has worn off
- A cast, splint, or boot that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise your leg above your heart. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, ice, and rest
- Pain, swelling, or tenderness in the calf that is new or getting worse
It is normal for the leg to be swollen, bruised, and sore for a while, and for it to feel numb or weak until a nerve block or spinal anesthetic wears off. Use your crutches, walker, or boot as directed and follow your weight-bearing instructions exactly. Call if something feels different from what you were told to expect.
Severe pain that keeps getting worse and is far more than expected, pain that gets much worse when you move or gently stretch your toes, or a leg that feels very tight or full, especially with tingling or burning. Pressure building inside the muscles is a surgical emergency. If a splint is held with an elastic wrap, loosen the wrap, but do not remove a hard cast yourself.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Hip fracture
Dr. Ward’s broken-hip page: fracture types, partial vs. total hip, nails, and the recovery plan.
Open pagePhysical therapy locations
Find a physical therapy clinic near you in Tucson and Oro Valley.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pageOrthoInfo: Femur shaft fractures
Patient education on femur fractures from the AAOS. OrthoInfo also covers tibial shaft fractures.
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