My mum (84) fractured her femur, still not allowed to weight bear after four weeks. Any suggestions?

Five years ago my Mom (86) had right knee replacement. Hospital stay was 3 nights (Medicare requires a minimum 3 nights in hospital in order to qualify for rehab facility) and was then transferred to rehab. She was to stay 3 weeks but after 2 weeks PT said “You really could go home” and she discharged herself a week early. She went home refusing in-home care but did allow a nurse to check on her daily. Third day home, she collapsed on the floor. Her 20+ year old hip replacement had loosened up and had caused her femur to fracture. Back to hospital for hip replacement surgery, stayed 3 nights and back to same rehab facility! This time she stayed 8 weeks. As I recall it was nearly 4 weeks before PT started allowing her to bear “some” and worked from there until she was able to bear her full weight and she was then discharged. BTW, she does not have osteoporosis but now at 91 doctors have said all you need is to get older and your bones will become soft. Her right hip is now in same situation before left femur break. She’s a ticking time bomb and refuses to use a cane or walker!! Good luck to your Mum and you.

You also mentioned pins were used in the surgery. That’s like fashioning a new bone in that there are multiple close together breaks (shattered). It takes a long time to heal, it can rebreak, pins can work their way out of position, all if weight is placed on the unhealed limb. That was a serious break. Your mum’s mobility might not be the same as pre accident.

I was charge nurse of an osteopaedic surgery floor in a hospital in New Orleans. Mixed in on that floor were cancer patients.

When I broke my ankle I was 6 weeks in a cast and another several weeks beyond that on crutches. Yes, ankles are more complex but I was a young woman at the time, an older woman who needed a walker even when she had full use of both legs is probably going to need a long time before she can safely stand without assistance.

Your mom could have osteoporosis which can be the reason weight bearing is not allowed. Was her injury spontaneous? Sometimes the bone fracture happens first and then the person falls. Osteoporosis is common in elderly folks. It can be due to the aging process, calcium & Vitamin D deficiency genetic predisposition. 
I don’t know if there are step down units where you are. There are still exercises your mom can do while non weighbearing. She can do ankle pumps and other isometric exercises while in bed. Ask her therapist for a list.
If they do send her home, assure that she will have caregivers. It must be so frustrating for her to remember not to put any weight on the leg. I know I would probably forget.
Good luck!

Gillam, I think there's another way to view the situation. The hospital staff are understandably concerned that the break hasn't sufficiently healed for her to be weight bearing. The therapist understands that constraint and is working on other aspects within the limitation of being nonweight bearing.

I'm not a medical person, but I assume part of the precaution is that an unhealed break isn't strong enough yet to be weight bearing. Is it subject to a second fracture? I don't know; that's a medical call. But it certainly is a factor.

I see this as good care, not to be challenged, but applauded.

I would ask the same question as Barb, in that I'm wondering what the basis of your concern is that she's not yet weight bearing. Did someone explain the issue to you while showing you x-rays of the break?

On the other hand, you're wise to address the return home, w/o any therapy. I assume from the use of the word "Mum" that you're in the UK? Isn't there a step down level of treatment, i.e., to a skilled nursing facility at which rehab is provided? This would be the protocol in the US, and I'm thinking it would be similar in the UK.

You're a thoughtful daughter to be so concerned, so perhaps channel that concern into finding a stepdown facility where she can get more PT and segue into weight bearing exercise for an eventual return home.

And definitely ask the doctors and social worker WHY they aren't considering PT and care at a facility where she can improve more before she goes home; otherwise, she's unprepared now.

Gillamtracy, the older we get the longer it takes for our bones to heal.

I know that happened with me. I had to wait two months before I could start any type of Rehab, and Rehab took me 3-4 months after x-rays gave me the go ahead. And my injury was a broken arm, so I can just imagine how long it would take for a broken leg.

Have you spoken to her doctor about when she will be able to bear weight? That's who decides. You want to ask about her prognosis, i.e. whether the doc thinks she'll be able to get back to walking with a walker or not.

I'd hardly say the physio sounds useless. Don't you think being able to transfer is a good thing? How is she going manage anywhere if the can't transfer?

You sound as though you must have a great deal of medical training, since you appear to believe she should be weight bearing already. May I ask what you base this observation on? Previous experience with femur breaks of your own or others in your family? Professional experience?

I might add that you should count yourself lucky you're in the UK. In the US, she would have been discharged home after two days in the hospital little no assistance provided at home.

How did she come to break her leg?

I'm not a doctor. Any bone I've ever broken has taken 6 weeks to heal.