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Orthopaedic Trauma Center
The information on these pages is to help you and your family understand geriatric bone fracture repair at Mass General and what to expect during fracture rehabilitation.
The information found on the following pages can be found in a PDF that you can download.
Your recovery from your injury will start in the hospital and continue in other settings.
Patients often spend about 4-5 days in the hospital after a fracture. Often patients continue their recovery in settings such as a rehabilitation hospital or skilled nursing facility.
The time you spend rehabilitating from your injury depends on how quickly you are able to recover and build the strength/balance you need to walk safely.
Your weight bearing status will be explained to you before you leave the hospital. If you are able to bear weight as tolerated, you can put more weight on your leg as it feels comfortable to do so.
If you are considered non-, touch down-, or partial weight bearing, your surgeon will evaluate you at your next appointment to determine whether it is safe for you to bear more weight.
Do not forget to use the ambulatory aid recommended by your surgeon/physiatrist.
If you broke your bone when you fell from your own height, you may have osteoporosis.
Osteoporosis is a condition where the bones become weak and can break from a minor fall or activity that would not normally cause a bone to break.
Lifestyle changes and certain medications prescribed by your physician can help prevent bone loss, increase bone density, and reduce your risk of future fractures.
Most fractures take one year to fully heal. The first four months are considered the healing phase, while the last eight months – called the remodeling phase – are when the bone attempts to become like it was prior to your injury. Over time your fractured bone becomes stronger and you should be able to resume many of your regular activities.
It depends on the kind of medication you are taking. If you are taking blood-thinning medication like aspirin, dalteparin, enoxaparin or warfarin, or antibiotics for infection you will need to take these drugs for as long as the doctor thinks is necessary. If you are taking pain medication, you should only take this medication when needed.
Surgeons, geriatricians, physical therapists, nurse practitioners, nurses and others will make sure you are ready for surgery and take care of you after surgery. A case manager will help your transition to a rehabilitation facility or to home with services. The entire care team will work with you to optimize your recovery and help you get back to the activities that are important to you.
The attending physicians are senior orthopedic surgeons who take overall responsibility for your care. They work closely with residents, who are training to be orthopedic surgeons and are available 24 hours a day, 7 days a week to provide care while you are in the hospital.
Our geriatric medicine physicians and nurse practitioner have specialized training in the care of patients 65 years and older and work with your surgeons and acute care nurse practitioners to optimize your care and rehabilitation.
The acute care nurse practitioners specialize in care of patients with traumatic injuries. These nurses work very closely with all physicians, nurses and other care providers involved in your care.
Clinic patients receive comprehensive care for their orthopedic injuries by a team of expert physicians and nurses. Patients who are recovering from orthopedic surgery will typically visit with their surgeon about 2 weeks after surgery to assess how their injury is healing and remove incision sutures or staples. Additional clinic visits will be scheduled as needed. The staff also helps patients coordinate care with other MGH services such as physical therapy, occupational therapy, and social services.
During your recovery at the hospital, a physician assistant for osteoporotic fracture care and prevention will visit with you to discuss a treatment plan to help reduce your risk of another broken bone from osteoporosis.
Surgeons, anesthesiologists, doctors, nurse practitioners and nurses will all ask:
Make sure you ask questions about your care and surgery. We are happy to answer all of your questions.
You will get daily visits from:
You can expect to feel:
Your goal will be to get out of bed and move when your doctor gives you the okay. Your physical therapist can give you exercises to do while you are in bed too.
You will begin eating and drinking again. The nursing staff will assist you with your care needs, such as providing medication, bathing and getting out of bed.
You will receive medication to manage your pain. You will wear compression boots wrapped around your lower leg that will massage your legs and help prevent blood clots.
Blood tests and x-rays will be done to manage your recovery. You may need a blood transfusion if you are anemic or lost a lot of blood.
Physical therapists will work with you to increase your strength and balance so that you can return to activities you enjoy.
Use the incentive spirometer to exercise your lungs and help prevent pneumonia.
How to prevent complications:
How to Treat Pain:
What to Keep in Mind:
Pain makes recovery from surgery more difficult and stressful for your body. It is important to take your pain medication to help your body heal.
You should take pain medication before physical therapy to get the most out of your session.
Most people who take narcotic pain medication for short periods of time as instructed do not become addicted to it.
If your pain medication is not working for you, we have other medications or non-pharmacological ways (like ice) to treat your pain. Tell us about your pain so we can help you!
Why are you at risk for constipation?
Treatment for Constipation
What is delirium?
A new, fluctuating change in mental status that is reversible and is frequently caused by several factors related to the patient’s injury and hospitalization.
Family and Friends: What can you do to help?
Delirium: What you may observe
Before you are discharged from Mass General, it is important for you and your family to make sure:
There are many skilled therapists, nurses and clinicians who will work with you daily to help you regain your independence, strength and movement.
A specific plan of care and goals will be determined with you and your family once you are transferred to the rehabilitation hospital.
You have a few options: Phone (7:00 am - 3:00 pm weekdays): Call our fracture liaison nurse practitioner at (617) 697-4806 Email (anytime): fractureMGH@partners.org Pager (Emergencies from 3:00 pm - 7:00 am weekdays, all weekends and holidays): (617) 280-9956
Before you leave the hospital, you will be given specific instructions about your scheduled follow-up appointment.
Typically you will have an appointment with your surgeon 2-3 weeks or 6 weeks after your surgery.
To increase your strength. To increase your balance. So you can move around, take care of yourself and enjoy your hobbies
Everyone’s speed of recovery is different and your physical therapist will work with you to determine the optimal amount of exercise you need to reach your goals.
Typically it takes 3 – 6 weeks to regain your strength with physical therapy.
Your physical therapist may include in your recovery: Strengthening Exercises: Simple muscular contractions using your body weight as resistance. Range-of-Motion Exercises: Helps you to flex and extend your injured joint. Stabilization Exercises: Helps you restore balance and strength to the muscles surrounding your injury.
Your surgeon will determine when it is safe for you to bear weight on your leg.
How much weight you can put on your leg depends on the type of fracture you sustained.
Placing weight (known as weight bearing), on your injured limb depends on how well your bone is healing and what type of surgery you had. X-rays are used by your orthopedic surgeon to confirm the status of your bone healing. Each fracture is different with different bones and fracture repairs healing at different rates. Your orthopedic surgeon will give you specific instructions regarding when you can safely put weight on your injured limb and how much weight is safe to place on it. Placing weight on your repaired limb before you are cleared to do so may damage it and put you at a higher risk of complications and increase your time to recover.
It is very important to follow the instructions given to you by your orthopedic surgeon, trauma nurse practitioners and physical therapists. Remember if you have any questions about your recovery please ask us to clarify your activity instructions!
When you stand or walk, place as much weight as feels comfortable on your affected leg. Let pain be your guide. If you feel pain, place less weight on the affected leg.
When you stand or walk, you may place some amount of weight on your affected leg to help you move while using an assistive device like a cane or walker. Exactly how much weight you can support will be specified by your surgeon and how to support your weight will be shown to you by your physical therapist.
When you stand or walk, you may put your foot down to touch the floor only for balance. Do not place actual weight on your affected leg.
Place no weight on your affected leg. Do not touch the floor with your affected leg. While you stand or walk, you must hold your affected leg off the floor.
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