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I was all set to go on a Sunday bike ride with a group of friends when I got THE call -- Mom fell. Dad didn't know what to do. We got her to the hospital and into surgery for a broken leg. The bottom end of her thigh bone was busted into three or four pieces. I found out after the fact that she has a titanium nail through the bone to hold it together. Is there anything special we should know about this kind of hardware?

Everyone dreads the call that tells them, Mom (or Dad) fell and broke something. Bone fractures in older adults can be disabling and even life-threatening. The surgeon often has to use metal plates, screws, or nails to hold the bone fragments together while they heal. This treatment approach is called internal fixation. Most fractures in older adults occur in the upper portion of the femur (thigh bone). Distal femoral fractures (at the bottom end of the femur) present a different type of problem. The bone is much wider at the distal end and more difficult to stabilize. Everything is even more challenging when the fracture is comminuted (broken into many little pieces). Fixation devices (commonly referred to as hardware) range anywhere from a single nail to a complex series of screws, washers, nuts, and metal plates. The type it sounds like your mother has is a simple bolt down through the bone called a femoral nail with smaller screws sideways through the fracture site and through the bolt. It's a fairly straightforward device that doesn't require any special care or feeding. The surgeon will give you instructions on what to watch for in terms of any complications, which can include observing for any signs or symptoms of implant failure, loosening, or infection. It sounds like you got your mother to the hospital quickly enough after the fall to avoid damaging the bone further.

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