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Dr.Tiwari
Dr.Tiwari, Doctor.
Category: Health
Satisfied Customers: 5256
Experience:  M.D.
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I had total hip replacement Jan 12/09. My femur cracked at

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I had total hip (left) replacement Jan 12/09. My femur cracked at its top during the surgery and a metal ring was put around it. X-rays show this crack is healing. I am 52 years old (female) and a bone scan shows I have no osteoporosis. The femur cracked because it was so narrow; too narrow for the smallest size of post they inserted. Since the surgery I have severe pins and needles in my left foot, which is excruciatingly painful. There is a strong pulse in the foot, but with activity, that foot becomes more red than the other. The left foot is always colder than the right, with activity or not. Even when the top of the left foot is somewhat warm, the underside of the foot is always ice cold, while the right foot is not. I'm terrified as to what's wrong. I have an appointment with a neurologist, but not for 7 weeks. If I could hear that this is likely to clear up or that I'm in no danger of losing my leg...I don't deal well with uncertainty, and am somewhat of a hypochondriac. I didn't have this nerve problem until after the surgery, and it showed up immediately after the surgery. As well, I have srong pins and needles on the front and side of my right thigh, which showed up right after the surgery. No matter how much physio I do, the muscles on the left leg feel tight and "shortenened," especially on the back of the leg. I had a spinal for the surgery, and the day after there were little blood blisters and a bumpy rash around where the spinal was given.
Submitted: 8 years ago.
Category: Health
Customer: replied 8 years ago.

Relist: No answer yet.

I had total hip (left) replacement Jan 12/09. My femur cracked at its top during the surgery and a metal ring was put around it. X-rays show this crack is healing. I am 52 years old (female) and a bone scan shows I have no osteoporosis. The femur cracked because it was so narrow; too narrow for the smallest size of post they inserted. Since the surgery I have severe pins and needles in my left foot, which is excruciatingly painful. There is a strong pulse in the foot, but with activity, that foot becomes more red than the other. The left foot is always colder than the right, with activity or not. Even when the top of the left foot is somewhat warm, the underside of the foot is always ice cold, while the right foot is not. I'm terrified as to what's wrong. I have an appointment with a neurologist, but not for 7 weeks. If I could hear that this is likely to clear up or that I'm in no danger of losing my leg...I don't deal well with uncertainty, and am somewhat of a hypochondriac. I didn't have this nerve problem until after the surgery, and it showed up immediately after the surgery. As well, I have srong pins and needles on the front and side of my right thigh, which showed up right after the surgery. No matter how much physio I do, the muscles on the left leg feel tight and "shortenened," especially on the back of the leg. I had a spinal for the surgery, and the day after there were little blood blisters and a bumpy rash around where the spinal was given.

 

Expert:  Dr.Tiwari replied 8 years ago.
Hello,
Are you also having any limp after your surgery?
Are you able to keep your limb straight whenever you relax it or there is some flexion at the knee?
Please reply.
Customer: replied 8 years ago.

I was using a walker until a few days ago. Now I use crutches. One crutch when at home, and both when going out, although I cannot walk far. I feel the leg is too weak.

 

I limp, and rock from side to side, if trying to walk without a crutch or walker. The right hip kind of swings up and out to compensate for the weakness in the left leg.

 

The left leg seems to stay straight when relaxed. I compared the two, and it seems the same as the right when they are both relaxed.

Expert:  Dr.Tiwari replied 8 years ago.
Sorry to ask more-
1.Are you able to keep your operated leg at 45 degree straight & up?
2.Is there any swelling in your operated leg or any severe pains?
Customer: replied 8 years ago.

I'm not sure I know what you mean by "straight & up." I am able to keep my leg bent at the knee at a 45-degree angle both when sitting and lying down. I am not able to raise my leg completely straight when lying down. It feels like too much pulling at the back of my leg. No matter how much physio I do, and how much stretching of the muscles on the back of the leg, they always feel shrunken and tight just a few hours later. I feel this tightness mostly at the back of the calf and back of the knee.

 

I can't see any swelling anywhere. The foot and ankle may be just a tiny bit swollen, but so little I can hardly tell. There are some very hard lumpy areas around the incision. I do not have severe pains except in the foot, from the pins and needles sensation, and on the right thigh, where I also have pins and needles.

 

Could this be something called Reflex Sympathetic Dystrophy Syndrome? Someone mentioned this to me today.

Expert:  Dr.Tiwari replied 8 years ago.
Feeling of severe pins & needles in operated leg with some weakness is inclining more for a nerve affection & with your answers i think you may not having REFLEX SYMPATHETIC DYSTROPHY(RSD) because the main feature of RSD is severe pain & vasomotor changes which manifests as the swelling ,redness,pitting edema ,stiffness of joints.Severe pain is so prominent feature of RSD that patient unable to move his limb.
   You may have a nerve injury of mild type that is neuropraxia which will recover in next 3-6 months with the good physiotherapy meanwhile you may have drugs like gabapentin which will help in easing such type of pains.
I think this will help you.
Regards.
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