### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello: I broke my femur just over 10 months ago. I underwent surgery to place a rod and nails in the leg. Bone growth has been consistently slow. At my 6 month x-ray the bone growth was progressing but still very slowly and the nails were in good shape. At 10 months the bone growth was not at the level my Dr. anticipated and the nail at the knee had broken. There was good evidence of union on the one side of the break but still lots to go on the other side. I had post-operative infection and open surgical wounds for the first 6 months. I am 50, overweight and T2 diabetic (well controlled). I am to have a CT scan to get a better look at the callous formation but my Dr. has mentioned that further surgery may be required to put another nail in and to ream around the bone marrow. The thought of more surgery terrifies me. If this surgical intervention is required, what does it entail and how limited will I be after the surgery? Can it be done with a local? Thanks in advance for any info you can share.

### output:

Hi, thank you for providing the brief history of you. A thorough clinical assessment with diagnostic is advised. With your history to understand is there are 2 factors which delayed your healing. 1. Post-operative infection and 2. High Blood sugar levels. This both has interfered in your healing. Also, the infection and high blood sugar levels are related to your weak immune system and weak metabolism from the before of the operation, so the healing is delayed. Now, since the bone is not healing, there is one possibility to try out, that is the bone graft. As bone graft usually helps to heal in non-healing fractures, provided the infection and blood glucose levels stays in control. In my clinical practice, patients respond well to bone graft and bone healing is faster. You can discuss the same with your surgeon as this will be of choice. RegardsJay In Chat Doctor. 