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    Includes Expert Content
    Broken Leg not healing in 70 yr aged woman
    wonderingt posted:
    My mother-in -aw was in a car accident last April and broke her femur. She had surgery placing a screw and a rod to hold in place during the healing process. Four months later, one of the screws broke and she had to have a second surgery to replace it and they also did bone grafting at that time because the bone was not healing. She recently went for her dr. visit and the new screw is now bent and the bone is still not healing. She may have to have 3rd surgery. How common is a screw "breaking"? Could her previous use of fosimax be slowing the bones from healing? She has been off the fosimax for 9 months now, since the time of the accident.
    bonebabe responded:
    I'm thinking her bone health is the cause of the slow healing, not the Fosamax. Also being off for 9 months won't get it out of the body, if that was the goal. It has a 10 year half life. If she's been on Fosamax, it was because of her bone density in the first place. Then to have a fracture and surgery too complicates it. Has she had fractures before this? How long was she on the Fosamax? What were her T-scores in the hip?
    Michael Lewiecki, MD, FACP, FACE responded:
    There are numerous causes for a nonunion or delayed union fracture, including poor nutrition, infection, metabolic bone disease, poor blood supply to the fracture site, and the nature of the fracture itself. Fosamax is not known to cause this problem. Evaluation and treatment should be a team effort with a good orthopedic surgeon, primary care physician, and perhaps a specialist in osteoporosis.
    wonderingt replied to bonebabe's response:
    Thank you for your reply! I will have to ask her about her T-scores, I am not sure but she did fall while mopping about four years ago and fractured her wrist. It healed in maybe a little longer than expected time frame. She has always been very active and she is really having a hard time with this prolonged recovery. She wants to be active again. She has been taking fosamax since 2002, believe.
    wonderingt replied to Michael Lewiecki, MD, FACP, FACE's response:
    Thank you for your reply!
    Poor blood supply? Would limited physical movement cause poor blood supply? She has no infection and eats fairly healthy. She was taken off fosamax I was wondering why? She has a great ortopedic surgeon etc. We are just baffled as to why it is so slow healing. She may have to have 3rd surgery to insert metal plates instead of just the rod and screw. She is doing all she knows to deal to allow it to heal?????
    Michael Lewiecki, MD, FACP, FACE replied to wonderingt's response:
    You have many good questions which need to be brought up with the physicians who are caring for her. Poor blood supply can be for many reasons, including damage to nearby blood vessels from the fracture itself. It sounds to me that a consultation with a physician in your area who has a special interest in osteoporosis would be a good idea. I am sure her primary care physician or orthopedist knows someone like that.
    wonderingt replied to Michael Lewiecki, MD, FACP, FACE's response:
    Thank you very much for the information. She has scheduled an appointment for tomorrow.

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