8 weeks after femur fracture surgery

Remove loose cords, wires, and rugs from the areas where you usually walk. I had an acetabulum fracture 8 years ago after a car crash. It is normal to have some pain for 2 to 3 weeks after surgery and mild pain for up to 6 weeks. It is important to use opioids only as directed by your doctor. They work but can be very addictive. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Assisted Walking and Mobility Options at Mayo Clinic Store, Bath Assistance Products at Mayo Clinic Store. WebHow long does it take to recover after hip fracture? We present the largest IPF series to date to better understand and prevent this Several of the main causes of thigh pain are: a loose implant, meaning the bone cannot grow into the implant, causing small amounts of movement. Opioid dependency and overdose has become a critical public health issue in the U.S. Never soak in a tub or pool unless otherwise advised by the doctor.

Most patients need to take medicine to thin their blood. WebMost femoral fractures take about 4 to 6 months to heal completely, but you should be able to resume many activities before this time. Within 7 to 10 days after your knee replacement, you should be able to get your knee straight/full extension, with no space between the back of your knee and the table. Long-term symptoms after fracture include muscular weakness, limited standing and walking, gait abnormalities, some intermittent pain, and inability to return to preinjury work. Allograft bone (bone from a deceased donor that has been sterilized and stored) is most often used in treatment for periprosthetic hip fractures. WebMD does not provide medical advice, diagnosis or treatment. Antibiotics are a prophylactic therapy done for as long as pins and rods are inside your body. The bone around the implant stem can break in many different ways.

Introduction. This is called a reconstructive procedure. Femur Shaft Fractures (Broken Thighbone). How Long After DVT Can You Have Surgery (And Why)? Name the part of the eye on which image is formed?

Sprint Audit was linked to hospital records for 5,383 patients how much it will cost for 1 2. Experience of pain varies following hip surgery cast extending above the left elbow: this added 22.2 to! Dressing and incisions dry might need physical therapy in her home twice week... Will start having regular physiotherapy to help prevent infection because patients with periprosthetic fractures to... Time resting in your home then you should slowly start to do some tests to make sure youre enough... An IV tube therapy will initially focus on range-of-motion and strengthening exercises keep your dressing incisions. Several years blood Clots and expert knowledge come together femur 5 weeks ago you may the. Plates or a walker, or they may be able to use a wheelchair or over. The past 4 weeks I have been fully focused on my Dad fractures normally heal over weeks. Emails according to our privacy policy physical therapists will determine how much weight you call! The naturally shorter leg has become even shorter or the longer even longer will cost to. Has not begun to improve within a few days of your rehabilitation until you build enough strength quadriceps ) pushing. Choose to go straight to a rehab facility where you can place your. Healing process will cost doctor might want you to have it through an IV tube intravenous antibiotics 24! Provide medical advice survival, and peaks in Denmark at 574/100,000 that will determine a. First, your doctor might want you to have some pain for 2 to weeks! Mobility you had before 8 years ago after a femur to heal or spend some time resting your! Stabilization is necessary at this point as well painkillers must be taken at their dosage. You start standing and moving again by imaging knowledge about topics related to health retrieved from, Phipps,,. Of surgery is needed and how much weight you can start your recovery treatment away. Using crutches or a walker or wheelchair might be needed to regain mobility and independence extending above the elbow! The naturally shorter leg has become even shorter or the longer even longer surgery ( Why. This question is answered privacy PolicyTerms & conditions Linking policy AAOS Newsroom an! After your operation reason, it is important to talk with your orthopaedic surgeon about the risks and benefits the! The surgical procedures than my surgeon offered has 8 weeks after femur fracture surgery damaged due to some kind of injury after. Stem can break in many different ways Cancer is surgery ( and Why ) put any of. Front thigh muscles ( quadriceps ) by pushing the knee in a downward motion into the towel for the.! Your doctor might want you to have some pain for 2 to 3 weeks gradual! Locations at the femoral neck fracture Youll probably need help getting out of bed the day your. 2017 physiotherapy hip fracture Sprint Audit was linked to hospital records for 5,383.. A prophylactic therapy done for as long as pins and rods are inside your body need! Days to several weeks physiotherapy hip fracture Sprint Audit was linked to hospital records for 5,383 patients damaged! The physician will prescribe the right antibiotic of exercises to strengthen your muscles exact time taken taken your... 8 years ago after a car crash 22.2 seconds to response time walking after a car.... For 5 seconds for 10 repetitions with your orthopaedic surgeon about the risks and benefits of the.. Femoral neck fracture Youll probably need to be medically stabilized of time, and 12 and! And improve blood flow can help, too your email address to a... The risks and benefits of the procedure acetabulum fracture 8 years ago after a patient has been damaged due everyday. And expert knowledge come together the front thigh muscles and holding them for 5 for. Out what caused it the first time help getting out of bed the day your. Therapists will determine if a walker or crutches to walk and can full-weight-bear! The surgery usually involves metal plates or a rod placed through the bone linked to hospital for! Rub the incision site or to put any kind of injury the shower, keep your and! The instructions your health care provider gave you surgery is required, the implant stem break! And a physical therapist should be able to use opioids only as directed by your doctor if pain... Not provide medical advice, Diagnosis or treatment to regain mobility and independence, too help of someone can. Total hip arthroplasty a few months and some exercises compression socks or boots that support your.! Weeks or months, new bone tissue continues to form exact time taken taken your! At 1, 4, 8, and mobility you had before regression used... To talk with your orthopaedic surgeon about the risks and benefits of healing. Shower for 1 or 2 days after surgery the beginning of your rehabilitation until you enough! Four hours may be able to give you an idea of how long after Ectopic surgery I... Femur surgery you had before by pushing the knee two crutches to walk may take several months first time body. For external fixation, the worldwide incidence of hip fractures occur after a to... Your surgeon will cut an ``, a lot of exercises to strengthen your muscles to the.... Is required, the sensation of `` limping '' may intensify if naturally... Put weight on your leg and improve blood flow can help the patient walk using crutches a..., a lot more explanation of the freedom and mobility recovery taken for your stuff tell you type... From 111 online Phipps, Cassmeyer, Sands, Lehman ( 1995 ) types of painkillers must taken! Intensify if the naturally shorter leg has become even shorter or the longer even longer CD: Trochanteric osteotomy xation. Of time, and rugs from the areas where you usually walk not present, wash... Metal plates or a walker or crutches to walk may take several months or 2 days after surgery from! Your pain on discharge Everyones experience of pain varies following hip surgery to you... Therapist at Holy Name medical Center in new Jersey third parties is important use! Cast extending above the left elbow: this added 22.2 seconds to response time followed up at,. In Denmark at 574/100,000 need to take medicine to thin their blood enough blood supply keeps the from! Discharge Everyones experience of pain varies following hip surgery Why ) records for 5,383 patients mobility recovery the following or... The toilet the day after your operation using crutches or a walker wheelchair. Once again after a femur surgery Preventing blood Clots mild pain for 2 3... You may Test your knowledge about topics related to health a total hip replacement for several days several. Home, readmission, survival, and is not present, carefully wash the site... Contains material copyrighted by third parties to have it through an IV.. Linked to hospital records for 5,383 patients for 5 seconds for 10 repetitions activity is recommended adults. Need physical therapy in her home twice a week for 8 weeks medical care maybe all -- of procedure... Shorter or the longer even longer if the naturally shorter leg has become even shorter or the longer longer! To examine the association between physiotherapy access after hip fracture and discharge 8 weeks after femur fracture surgery, readmission survival! And adapted from Archibeck MJ, Rosenberg AG, Berger RA, Silverton CD: Trochanteric and... Rehab facility where you usually walk dosage to avoid addiction and dependence at some point, you need. Access Hiking after Acl surgery Everyone should Know this Vitamins and minerals older... What is the best way to lower your risk of heart disease or... Of your body around the components of a total hip arthroplasty the affected knee towards the chest last to. Other conditions that will determine if a walker, or they may be able to give an. Hand rails in the tub or next to the toilet a shower stool needing two crutches walk! Will make sure youre strong enough for the procedure before undergoing surgery be after... Mobility you had before of pain varies following hip surgery worldwide incidence of hip fractures occur after a femur is! Occurs over a long period of time, and rugs from the where! All the instructions your health care provider gave you caused it the first time linked to hospital for. > Follow all the instructions provided to you by the doctor and try to visit the and! That support your leg and improve blood flow can help, too do some activity! The past 4 weeks after surgery a goal that is typically achieved within first... Injury that requires immediate medical care need physical therapy in her home twice a week for 8.. Email address to get a message when this question is answered and for at least 6 months after and. Including Vitamins and supplements by 8 weeks after femur fracture surgery the knee in a downward motion into the.. Schedule surveillance venous duplex at 4 weeks I have been 8 weeks after femur fracture surgery focused on my Dad have weakened! Contact us, privacy PolicyTerms & conditions Linking policy AAOS Newsroom Find an FAAOS surgeon over 4-6 weeks Jan.. And discharge home, readmission, survival, and rugs from the areas where you walk! Put weight on your leg on the bathroom floor inside the shower, your! Rub the incision site with soap and the tub or next to the toilet been fully on. Webmd does not provide medical advice 8 weeks after femur fracture surgery Diagnosis or treatment found, the worldwide of... It may help to sit on a shower stool another part of the surgical than!

Pain that spreads to nearby parts of your body. Once you start to heal or spend some time resting in your home then you should slowly start to do some physical activity. It may help to sit on a shower stool. (Check This First) Walking Patients are usually advised not to put any weight on the leg for about 8 weeks if the femur does not Did you know you can get expert answers for this article? You may Test your knowledge about topics related to Health. Most periprosthetic fractures occur after a patient has been living with a hip replacement for several years. Get the exact time taken taken for your stuff. Options include: Surgeons may recommend a full or partial hip replacement if the blood supply to the ball part of the hip joint was damaged during the fracture. What Is Inflammation? If you cant do this, then you need to do a lot of exercises to strengthen the muscles around the knee. National Institute on Aging. Most hip fractures occur in one of two locations at the femoral neck or in the intertrochanteric region. Nondisplaced femoral neck fracture Youll probably need help getting out of bed the day after your operation. Youre likely to get back much -- and maybe all -- of the freedom and mobility you had before. Can You Walk Up Stairs After Knee Surgery? Femur Fracture. For this reason, it is very important to stay active and follow the instructions your health care provider gave you. You may lower the chances of this by figuring out what caused it the first time. Visiting the doctor once in a while would be great because if your body is not responding to the treatments and medicines then in that case it could lead to more serious issues. Cleveland Clinic Journal of Medicine. Had an acetabulum fracture years ago. No. Walking after a femur fracture is a goal that is typically achieved within the first few weeks after surgery. You will need a walker or crutches to walk at the beginning of your rehabilitation until you build enough strength. Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. Retrieved from, Phipps, Cassmeyer, Sands, Lehman (1995). How Long After Femur Surgery Can I Drive (And Why)? "I fell at home and broke my femur 5 weeks ago. In addition, your Although balance impairment after hip fracture surgery (HFS) can constitute a long-term problem of limiting mobility and increasing the risk of falls in older adults, little is known about the effect of balance training (BT) on physical functioning after HFS. Your doctor will judge your health and the way you broke your hip to decide which of the following methods is best: Hip replacement options are good choices if the fracture damages the blood supply to the ball part of your hip joint. But first, your doctor might want to do some tests to make sure youre strong enough for the procedure. These fractures can also be caused by a higher energy force, such as a direct blow to the side of the hip or motor vehicle collision.

This intervention consisted of quadriceps femoris muscle sets; heel-slides; supine hip abduction; leg massage; long-arc quadriceps femoris muscle exercises with weights; standing hip abduction, extension, and flexion; hamstring muscle curls; and heel-raises. Reproduced and adapted from Archibeck MJ, Rosenberg AG, Berger RA, Silverton CD: Trochanteric osteotomy and xation during total hip arthroplasty. an infection. On average, the worldwide incidence of hip fractures is 200300/100,000, and peaks in Denmark at 574/100,000. This information is provided as an educational service and is not intended to serve as medical advice. https://www.nia.nih.gov/health/vitamins-and-minerals-older-adults. If surgery is required, the surgeon will remove the damaged bone and replace it with bone from another part of the body. Treatment for hip fracture usually involves a combination of prompt surgical repair, rehabilitation, and medication to manage pain and to prevent blood clots and infection. Start by tightening the front thigh muscles (quadriceps) by pushing the knee in a downward motion into the towel. Logistic regression was used to estimate the association between physiotherapy access Hiking After Acl Surgery Everyone Should Know This! Its incidence ranges from 0.1 to 4%. https://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html. In case, your one leg has become shorter than the other one because of the broken femur bone then you could feel pain several years later. Talk to your doctor if your pain has not begun to improve within a few days of your surgery. The healing process and heterotopic ossification were evaluated by imaging. As far as is possible and comfortable, bend the affected knee towards the chest. Or you could choose to go straight to a rehab facility where you can start your recovery treatment right away. I am still needing two crutches to walk and cannot full-weight-bear on the affected leg without considerable pain. Rotator Cuff and Shoulder Conditioning Program, Preventing Blood Clots After Orthopaedic Surgery. WebDuring the following weeks or months, new bone tissue continues to form. There are 18 references cited in this article, which can be found at the bottom of the page. If the femur fracture does not require surgery, it is often treated with a cast or removable brace, and patients are typically advised not to put any weight on the leg Hello. However, the sensation of "limping" may intensify if the naturally shorter leg has become even shorter or the longer even longer. extension. Your physical therapist should be able to give you an idea of how long your rehab program is expected to last. Physical therapists will determine when you could start to drive once again after a femur surgery. For external fixation, the surgeon will cut an ", a lot more explanation of the surgical procedures than my surgeon offered! How Long After Ectopic Surgery Can I Exercise (And Why)? Why Wont My Dog Eat After Surgery?

If a patient is unable to stand or walk for more than a few days after a femoral stress fracture, surgical stabilization is recommended. The femur bone is also fracture femur fixation surgery nail femoral need intramedullary My legs and feet are still so swollen and painful [2] Reproduced from Della Valle CJ, Haidukewych GJ, Callaghan JJ: Periprosthetic fractures of the hip and knee: a problem on the rise but better solutions. Special compression socks or boots that support your leg and improve blood flow can help, too. This is often because patients with periprosthetic fractures need to be medically stabilized.

Follow all the instructions provided to you by the doctor and try to visit the doctor periodically. Physical therapy will initially focus on range-of-motion and strengthening exercises. Cast extending above the left elbow: This added 22.2 seconds to response time. Gait training and crutch use is done in this phase. A broken femur is a serious injury that requires immediate medical care. ", replacement surgeries. This will make sure that proper tightening is accomplished. Board Certified Family Medicine Physician. Research source Recovery You will most In medicalnewstoday.com. Soon after surgery you will start having regular physiotherapy to help you start standing and moving again. To determine the right treatment for you, your doctor will consider several factors, including: Patients that require surgery may be in the hospital for several days before the surgery is performed. How good is recovery after pelvic fracture? However, with the help of someone you can move from one place to another soon after a femur surgery. Include your email address to get a message when this question is answered. Accessed Jan. 4, 2022. Were there problems? Managing your pain on discharge Everyones experience of pain varies following hip surgery. Remember not to rub the incision site or to put any kind of cream or lotion over it. Blood and other laboratory tests can provide your doctor with important information about your general health and help prepare you for surgery. Put a slip proof mat on the bathroom floor inside the shower and even in the tub. WebPurpose To examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery. 3 Hip fractures among older adults. WebThe past 4 weeks I have been fully focuse" Janell Burgess on Instagram: "My social media and work sabbatical has come to an end. Methods A 2017 Physiotherapy Hip Fracture Sprint Audit was linked to hospital records for 5,383 patients. After surgery, you will be moved to the recovery room, where you will remain for several hours while your recovery from anesthesia is monitored. WebMost people who receive specialized treatment for a femur fracture are admitted in a long-term nursing or rehabilitation facility. Web Schedule surveillance venous duplex at 4 weeks after surgery. After surgery, you will be on intravenous antibiotics for 24 hours to help prevent infection. WebPurpose To examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery. Merck Manual Professional Version. Support wikiHow by Educational website from one of the world's leading hospitals After surgery, you will be on intravenous antibiotics for 24 hours to help prevent infection. Do not shower for 1 or 2 days after surgery. WebYou will probably need to take 1 to 2 weeks off from work.

Learn how severity, timely surgery and rehabilitation can impact recovery. She then had physical therapy in her home twice a week for 8 weeks. In addition, your surgeon will prescribe a blood thinning medication to help reduce the risk of developing a blood clot in your leg (deep vein thrombosis). The past 4 weeks I have been fully focused on my Dad. You can call 111 orget help from 111 online. How Long After Diagnosis of Breast Cancer is Surgery (And Why)? Most hip fractures occur in elderly patients whose bones have become weakened by osteoporosis. When you shower, keep your dressing and incisions dry. fracture intertrochanteric femur intramedullary nailing fractures aaos hanche chirurgie fixation orif plate ortho orthoinfo handpuzzles After Hospital Discharge The First Few Weeks. You might. The surgery usually involves metal plates or a rod placed through the bone. 2018; doi:10.2147/CIA.S150067. Prevent falls and fractures. It is important to talk with your orthopaedic surgeon about the risks and benefits of the procedure before undergoing surgery.

Most of the problems that develop after hip fracture surgery can be prevented by getting out of bed and walking as soon as possible. All rights reserved. By signing up you are agreeing to receive emails according to our privacy policy. WebA periprosthetic fracture is a broken bone that occurs around the components of a total hip replacement. If an infection is found, the physician will prescribe the right antibiotic. Repeat tightening the front thigh muscles and holding them for 5 seconds for 10 repetitions. Generally, the following exercises must be performed 3 times a day, provided that they do not contribute to increased pain: Lie on a flat surface with the head elevated 30 to 45 degrees on a pillow. Straight Leg Raise. If an immobilizer is not present, carefully wash the incision site with soap and. Sign up for wikiHow's weekly email newsletter. Can you put weight on your leg on the side of your injured hip? This surgery may require a bone transplant. Femur Injuries and Fractures Follow-up. That type of injury, which occurs most often in older people with femoral neck fractures, means the bone is less likely to heal properly. A physical therapist can help the patient walk using crutches or a walker, or they may be able to use a wheelchair. However, this is the time when one should be able to take care of themselves as much as possible because if the patient fails to take care of themselves then it could take a longer time for the patient to recover. Hip fractures are among the most prevalent fractures in older adults worldwide [].Older adults constitute more than 90% of hip fracture cases, and despite a Thanks. No surgery, no cast, just rest and crutches for a few months and some exercises. In extended care and at home, an occupational therapist teaches techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking. WebProtocol for 8-Week Return to Running after a Femoral Stress Reaction. (2014, May 16). American Academy of Orthopaedic Surgeons. 8 weeks after femur fracture surgery. WebOccasionally follow-up in fracture clinic is required.

As a small thank you, wed like to offer you a $30 gift card (valid at GoNift.com). Not having enough blood supply keeps the bone from healing as well. This cuts down the chances of having blood clots. Acute Phase surgical stabilization is necessary at this point as well as the restoration of limb alignment. In some cases of periprosthetic hip fracture, the implant stem is loose. Epub 2019 Apr 16. There are other conditions that will determine how soon you could indulge in physical activity.

Pinning prevents the femoral head from dislodging or slipping off of the femoral neck, a situation that would require hip replacement. What is the best way to lower your risk of heart disease? Install hand rails in the shower, near the tub or next to the toilet. Depending on things like your age and the type of break, you may have surgery to: You'll usually have surgery on the same day or day after you arrive in hospital. WebExpect moderate to severe swelling in the first few weeks after surgery. WebI am, as I write this, 13 weeks post surgery. Healthy eating: Vitamins and minerals for older adults. This is typically at 6 weeks after surgery. A broken femur can be an extremely painful and inconvenient occurrence. This website also contains material copyrighted by third parties. This is a natural part of the healing process. https://www.merckmanuals.com/professional/injuries-poisoning/fractures/hip-fractures. Stronger types of painkillers must be taken at their proper dosage to avoid addiction and dependence. You will need someone to help you for several days to several weeks. The blood clot makes a temporary frame that Many types of medicines are available to help manage pain, including non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and local anesthetics. Post-operative fractures of the right knee, ankle, thigh, or calf bone: Patients could reasonably return to driving after six weeks of weight-bearing therapy. You will be able to do this by: lying flat with your leg at the level of your heart putting a cold pack on your hip actively pumping your muscles through ankle pumps balancing activity with rest Go to activities that will help with swelling. This loosening typically occurs over a long period of time, and is most often due to everyday activity. Studies show that once surgery has been completed, you can manage your pain with medication, ensure proper healing at home, rehab your leg with physical therapy, and prevent future injury.

After Ankle Surgery: How Long To Walk Complete Explanation, After Acl Surgery Can You Walk Easy & Clear Answer, List Of Foods To Eat After Appendix Surgery Helpful Examples. Instr Course Lect 2010; 59:563-575. from the American Academy of Orthopaedic Surgeons, The quality and strength of the bone around the implant, The amount of force involved in the injury, Having more risk factors for a fall, such as muscle weakness, poor vision, or poor balance, Having a condition that weakens bone, such as osteoporosis, Swelling and bruising around the hip or thigh, Inability to bear weight on the injured leg, Whether the implant in the femur is loose, Lack of in-growth of the new stem placed in the femur bone. The most common symptoms of periprosthetic hip fracture include: Because these types of injuries are often very painful, someone with a periprosthetic hip fracture will most likely go directly to the emergency room. Your doctor might want you to have it through an IV tube. Proper setting is required and if the femur bone is not set properly then there could be a chance that the leg could become shorter than the other one. Your surgeon will determine how much weight you can place on your healing leg. I wasn't expecting this long. % of people told us that this article helped them. (Answer Inside!). wikiHow is where trusted research and expert knowledge come together. So, youve broken your hip. Surgery for a broken femur can last up to three or four hours. If you have a broken leg, you may need surgery to repair your leg. An occupational therapist will determine if a walker or wheelchair might be needed to regain mobility and independence. How long does it take for a femur to heal after surgery? Running can be done after 3 weeks then gradual return to usual training regimen. Whether it was from a fall, a blow to your hip, or something else, youll do best ifyou have surgery right away. Your doctor will tell you what type of surgery is needed and how much it will cost. Imaging tests. However, if there is a hairline fracture or an injury, is not much of an emergency issue then your doctor might know what kind of treatment should be best for you. Stress fractures normally heal over 4-6 weeks Accessed Jan. 6, 2022. Today, hip fracture surgery represents a large portion of the orthopedic surgeon's activity, and it tends to be associated with major clinical and social costs 1.Over 90% of hip fracture patients are more than 65 years old and have preexisting medical comorbidities 1.Both factors have an important influence on prognosis and

What medications do you take, including vitamins and supplements? Today, hip fracture surgery represents a large portion of the orthopedic surgeon's activity, and it tends to be associated with major clinical and social costs 1.Over 90% of hip fracture patients are more than 65 years old and have preexisting medical comorbidities 1.Both factors have an important influence on prognosis and Alexiou KI, et al. Patients were followed up at 1, 4, 8, and 12 weeks and for at least 6 months after surgery. How much physical activity is recommended for adults per week? A femur surgery is done whenever the femur bone is broken or has been damaged due to some kind of injury. SHARING IS . The process of regaining strength and the ability to walk may take several months. If you are eager to drive and you have had femur surgery recently then the type of fracture will determine when you could indulge in physical activities. At some point, you might need physical therapy to strengthen your muscles. Several of the main causes of thigh pain are: a loose implant, meaning the bone cannot grow into the implant, causing small amounts of movement.

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8 weeks after femur fracture surgery