metal rod in femur causing pain

Surgical Treatment of Type 31-A1 Two-part Intertrochanteric Femur Fractures: Is Proximal Femoral Nail Superior to Dynamic Hip Screw Fixation? Didn't find the answer you were looking for? Risk factors for intramedullary nail breakage in proximal femoral fractures: a 10-year retrospective review. Read More, Asked for Male, 37 Years Recovery v, Stretching exercises and strength exercises with physiotherapy treatment after doing that an hour letter while getting out of the car the pain was so severe on my left thigh severe muscle spasm kept me in the car for over 2 hours. I am so sorry to hear your trouble. Your doctor also needs to know if you take any medications. We found a strong association between heterotopic bone formation and pain, but it is uncertain whether this is the true cause or merely an indication of some other factor such as traumatic damage to the glutei during insertion of the nail. I was hit by a car in late March and broke my left tibia. v, It depends on patient's fracture pattern,age, work profile and needs whether a fracture should be treated conservatively or with operation. What is the precautionary measure to be taken before being operated for removal. My story is very similar to yours. Consider having a full orthopedic re-evaluation with updated imaging. Distal femur fractures most often occur either in older people whose bones are weak, or in younger people who have high energy injuries, such as from a car crash. Your physical therapist is like a coach guiding you through your rehabilitation. Dubey S, Iyer RD, Azam MQ, Sarkar B, Nongdamba H. Malays Orthop J. 619 Views If the metal is removed, will the screws holes heal naturally, how long does the holes take to fill? We have many members talking about knee replacements here on Connect, many of which have been very recent. Read More, Asked for Female, 26 Years I think the suggestions you have sound like they are fairly knowledgeable. Can you please suggest best diagnosis and doctor for this? Intramedullary nailing of the femoral shaft: a prospective, randomized study. Thigh Pain and Peri-Implant Fractures with the Use of Short Cephalo-medullary Nails: A Retrospective Study of 122 Patients. In many cases, the devices used to fix a fracture break or loosen when the fracture fails to heal. If you want to get your plate removed, you can , but let your know about it. Stretching exercises and strength exercises with physiotherapy treatment. and transmitted securely. WebSymptoms of metallosis. J Orthop Trauma. No arthritis, the bone has healed perfectly, the rod and pins are in the right place. WebDr. experts in Seattle area that have experience REMOVING BROKEN PROXIMAL FEMORAL NAIL, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life, Platelet-Rich Plasma Therapy: Big Promise, Big Questions, Ankle Sprains: Causes, Consequences and Cures. She said it was a cramp in horrible pain she was crying and holding her leg. PMC Injury. It is a trapezoidal shaped bone that makes up the top of your joint and sits just behind your knee cap. Sometimes these fractures extend into the knee joint and separate the surface of the bone into a few (or many) parts. This provides support while the bone heals. doi: 10.1097/BOT.0000000000000185. FOIA This procedure is used to treat femoral neck fractures of the hip as well as other serious femoral injuries. The rod is then pulled out in general that too comes out easily. Your commitment to physical therapy and making healthy choices can make a big difference in how well you recover. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Consult online or visit fever clinic sec 47 3 months later I was walking with a limp. Doctors typically provide answers within 24 hours. Copyright 2020 - 2023 Stamina Comfort Inc. Is the metal rod in a femur fracture permanent? 6920 Views Read More, Asked for Male, 31 Years So my concern is just how much difference might arise with that additional work being added to the TKR? We offer this Site AS IS and without any warranties. How to bounce back fast from an ankle sprain - and stay pain free. Thank u, I have undergone Wrist Distal Radius orif 2 months back. Read More. She's lucky to have had your support. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. I was an orthopedic nurse. not good results on ankle replacements I hear. For example, if you are a smoker, your doctor or therapist may recommend that you quit. Connect with thousands of patients and caregivers for support, practical information, and answers. My doctor and I have discussed several options, ranging from no stabilizer to using bone to replace the metal rod. Had screws in knee and hip removed, the rod in femur is still in. The distal femur makes up the top part of your knee joint. You may be given pain medicine for you to take every eight hours during your stay in the hospital. WebHow is a metal rod placed in the femur? Open fractures expose the fracture site to the environment. This cartilage protects and cushions the bone when you bend and straighten your knee. 1996 Jan;40(1):10-6. doi: 10.1097/00005373-199601000-00003. As we age, our bones get thinner. I have had a tibia plateau break but the metal plate in my leg sits out from the bone -is this normal - I can feel the plate if I kneel - it seems to sit on the floor separate from my knee - is this normal? We offer this Site AS IS and without any warranties. WebIf youve fallen or been injured, here are signs you may have a broken femur: Youre in severe pain. Plates and screws: Plates and screws are used to reassemble the bone in those cases where the injury resulted in multiple bone fragments. I have the same issues but from my leg to my ankle. Patellofemoral pain and what to do about it. Didn't find the answer you were looking for? I would not have even thought that was possible! Titanium rod: The best source to get the answer to this question would be to contact the manufacturer of the same. Interested in more discussions like this? 2017 Feb;99(2):145-150. doi: 10.1308/rcsann.2016.0297. Heterotopic ossification around the hip with intramedullary nailing of the femur. If your bone was fractured in many pieces or your bone is weak, it may take longer to heal, and it may be a longer time before your doctor recommends motion activities. Distal femur fractures that enter the the knee joint may heal with a defect in the normally smooth surface of the joint. Now my fracture has been completely healed but i feel pain due to implant in my leg. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. On 17 th my surgical operation for treatment of ankle fracture was done with inserted steel plates with screw, my concern is that is safe to steel inserted in leg. She was 68 when had TKR and 74 when fractured her femoral bone just below the hip bone. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. Walk with stick support Hello , My father is 40 years old and went through a terrible accident in 2003 because of which his left leg was braked at several places Had ORIF surgery - a plate and six screws. I am very familiar with rehabbing a TKR, since my mom and mother-in-law have both had that experience. Read More, Asked for Female, 27 Years Tips for preventing one of the most common types of knee injury. I fractured my left femur and a compound open fracture of my right ankle and also fractured my left tibia. 77 Views I'm 68 had accidental fall in july. I get pain in my femur. The question asked on this page is a free question. After two years of this surgery, I don't have any pain normally when I sit. In this type of operation, metal pins or screws are placed into the middle of the femur and tibia (shinbone). WebA long metal rod together with a large secondary (lag) screw or with screws that capture the neck and head of the femur. Herpes sores blister, then burst, scab and heal. This surgical method stabilizes severe femur fractures by inserting a metal rod into the femur's core. Talk to your doctor if your pain has not begun to improve within a few days of your treatment. Read More, Asked for Male, 21 Years What is the minimum period I have to wait for removing my metal plate, since I don't want to have metal inside me. doi: 10.7759/cureus.4110. He or she will assess your pain level (if any), strength, and knee motion, and also how well you are able to perform daily activities. Is it Ok for me to remove this implant? 8600 Rockville Pike Some mornings I have to manually lift my left leg off of my right leg to get out of bed. Can be easily removed. My horse fell ontop of me in 2008. v, to poochho Now there is plate in my arm. This surgical method stabilizes severe femur fractures by inserting a metal rod into the femur's core. Cameron CD, Meek RN, Blachut PA, O'Brien PJ, Pate GC. Please enable it to take advantage of the complete set of features! Arthritis caused by fracture or injury is called post-traumatic arthritis. I am a 22 year old female . I saw an orthopedic last week and x-rays showed that the hardware in my femur is all perfectly in place. Only by words guidance is futile. Your doctor or therapist may be able to recommend professional services to help you quit smoking. This may take up to a year or more. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Surgery was performed and I had a rod inserted just below the knee to th 10 year old skateboarder here. v, Hi . 125 Views Having diabetes, and 3 years back when fracture happened we put plate in leg. Eur J Trauma Emerg Surg. If there is a metal rod in the leg that causes pain, the implant may need to be removed. In both the elderly and the young, the breaks may extend into the knee joint and may shatter the bone into many pieces. During this time, you will need crutches or a walker to move around. Epub 2017 May 5. Still, a second opinion never hurts. Safe nahi hoga to koi doctor kaise operate karega v, Looks like dengue. v, Post the x rays Hip implants are supposed to last up to 15-20 years. I didn't get any hit in that place. After getting the hardware removed I walked out of the hospital! Pain after surgery might be present for couple of weeks weeks but slowly it will come down. These fractures treated with traction (left) and casting (right) are not lined up and will not successfully heal. My L femur was the least severely broken bone as it was a "clean" break, whereas my R ankle was crushed (the joint required bone grafts), and the bones in my L forearm were shattered (literally in pieces). I have experienced this sharp yet aching pain you described every day since my initial injury. This is important since surgery can cause nausea, vomiting, and diarrhea. Check ur sugar levels by doin HbA1c and serum sugar, to poochho I plan on getting the hardware removed in another two or three months because I can't put arm Hello everyone. 394 Views v, Yes, but needs to be assessed after a fresh x ray. I am now perfectly fine. Her Ortho surgeon was very pleased with her dramatic recovery and didn't feel her TKR 6 yrs earlier had played a part in her breaking the femoral rodrather, lack of muscle strengh, causing balance issues and not finishing her PT the first time seemed to be the culprit. The surgeon may also place a screw-attached plate adjacent to your bone. The distal femur is where the bone flares out like an upside-down funnel. When I bend in front for typing or something else, then when I lie stand , then a sound occur in that place and after that I feel satisfaction, as similar to finger crack. Read More, Asked for Male, 21 Years If the provider does not document that the pain is due to the fracture or due to the implant, then it cannot be coded that way. I'm a mom of two young children-ages 1 1/2 & 5 who I want to be able to be active with and I cannot imagine living with this current level of pain every day from here on out. Should I still have pain four months after ORIF Olecranon elbow surgery? A coordinator will follow up to see if Mayo Clinic is right for you. Of the 80 patients, 27 had the implant removed after 18 months, 17 of them because of pain. It is one of the most common treatments for a femur shaft fracture and. Doctors tell give you a way linger recovery rate than you really need. The https:// ensures that you are connecting to the This may require as much as 3 months or more of healing before weightbearing can be done safely. However it has be causing a lot of pain ever since I got it. Bharosa to karo doctor pe Talk to experienced orthopedist online and get your health questions answered in just 5 minutes. Read More, Asked for Female, 28 Years However, considering its been 34 years since the plate was implanted there is a risk of difficulty in removing the implant complet. Everything healed well but then 6 months later she started getting severe leg pain 8-9 on scale of 10. At a mean of 21 months after operation 33 patients had residual pain severe enough to interfere with their lifestyle or mobility. Read More, Asked for Male, 30 Years Once your doctor determines that your fracture is stable enough, you can begin weightbearing activities. My left leg has went an operation to remove a bone in foot replaced by clips 3 live stable pin shape and doctors advised to come back for treatment due study 5 years passed what can I do now. God speed and good luck. Some patients can also have concerns with the hardware later in life. There will be blood loss during your surgery. (Right)A comminuted fracture that extends into the knee joint and upwards into the femoral shaft. This procedure is called a revision and may be necessary if the implant is loose or not supported by surrounding good bone. Spartan Med Res J. After doing any work very tired feel. Thank you in advance :-). HHS Vulnerability Disclosure, Help She gets them approximately once a month. Why the pus coming from my hip is not stopped ? When the femur breaks into several pieces, new bone will grow and fill in gaps during the healing process. WebOpen reduction and internal fixation (ORIF) is surgery used to stabilize and heal a broken bone. Read More, Asked for Male, 30 Years AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. I fractured my femur(neck) in January and now my surgeon tells me the bone has healed completely. However, considering its been 34 years since the plate was implanted there is a risk of difficulty in removing the implant complet I got a major fracture in my right leg in year 2013. Copyright 2017, Practo. Are you questioning whether to get a second opinion? Tips for preventing one of the most common types of knee injury. Whether your fracture is treated with surgery or not, your doctor will most likely discourage weightbearing until some healing has occurred. I have always had constant burning and have learned to live with it with a daily regiment of Neurontin (Gabapentin) to ease somewhat but this nightly throbbing and aching.. OH MAN! Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip: a randomized controlled study with in-depth functional outcome results. Does your doctor think there is no remedy for this and it will be a chronic situation? He also gets some pain going from his back down the leg that reminds me of sciatica. Cureus. Also, more serious injuries have been reported after surgery to fix femoral fractures without inserting a metal rod. Hard to say from this description alone. In six of these 17, the pain was not relieved. 1. Read More, Asked for Female, 22 Years I have an metallic implant (DHS plate) in my leg which was placed during surgery to correct fracture of femur bone. Not sure about stem cell replacement. In cases of severe arthritis that limits activity, a total knee replacement may be the best option to relieve symptoms. However, I agree with Debbra, I would get a second opinion. Disclaimer, National Library of Medicine Bookshelf Stretch Calves I have sore throat sicnce 1 yr,when it become wrost i feel too much pain in foot plate,blood ,TB, HIV repaorts are normal,visited toom much dr all prescribed antibiotics but no relief. 237 Views 1.minimum period would be atleast one year for the bone to completely heal and remodel and its completely safe to remove after a year For potential or actual medical emergencies, immediately call 911 or your local emergency service. From your post, it sounds as if you moved to SC to be with your mom so I'm guessing you use Mayo JAX. I'm 68 and I've had two. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Webleft femur was broke 6 inches above knee a rod was put by going through top of femur the rod is threaded a few inches on both ends no other screws used this was done in 1984. Connect with thousands of patients and caregivers for support and answers. She was hospitalized 4 times and all they did was give her mass doses of pain killers. (That was probably the longest distance she had walked in 20 years! Read More, Asked for Male, 45 Years I also previously had a rod in my femur from 1971 to 1973. During pussing right shoulder to back occur some pain in shoulder plate on right side. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. You can consult with me personally in detail on your issues. Early motion sometimes starts with passive exercise: a physical therapist will gently move your knee for you, or your knee may be placed in a continuous passive motion machine that cradles and moves your leg. 13110 Views is it possible to remove this implant after 8 yrs. If you want to get your plate removed, you can , but let your know about it. Anyone else been in this situation?? I recently got my covid vaccine in that same arm. But they also said that 15% of people who have implants of hardware,thier bodies dont accept it,and that I fell into that 15%. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Bone grafts may be obtained from the patient (most often taken from the pelvis) or from a tissue bank (cadaver bone). Our daughter wasin a car accident and broke her femur in 3 places so they inserted a titanium rod. I'm just wondering if anyone out there has had a similar experience and/or if anyone knows of a specialist who can help us. Because the knee is the largest weightbearing joint in the body, any defect can damage the protective articular cartilage and, over time, result in arthritis. Jang Y, Kempton LB, Mckinley TO, Sorkin AT. Location. v, Avoid computer work. One suggestion has been removal of the rod and later after healing do the TKA. Hi- I have had a metal rod in my leg, above knee, for 3 years now due to a break. As a result, I have a titanium rod and screws in the head and above my knee. Some doctors believe that smoking may prevent bone from healing. As a result, I required nearly 10 hours of surgery to repair two badly broken legs and L forearm. I had done my arm surgery 7yr ago due to bone tumor. My Mother had a femoral rod put in her leg AFTER she had her TKR however. Within 2 mths of moving to her new home, she fell and (get this) broke the titanium rod in her leg.and then after redoing that surgery, she fell again 4 mths later and did it again. v, Can be easily removed. By using this Site you agree to the following, By using this Site you agree to the following, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life, Platelet-Rich Plasma Therapy: Big Promise, Big Questions, Ankle Sprains: Causes, Consequences and Cures. Elderly people with distal femur fractures typically have poor bone quality. Because of newer techniques and special materials, the results of surgical treatment are good, even in older patients who have poor bone quality. The surgeon inserts a rod or big nail into the core of the bone in the most typical procedure to treat a femur fracture. Nonsurgical treatment options for distal femur fractures include: Patients with distal femoral fractures of all ages do best when they can be up and moving soon after treatment (such as moving from a bed to a chair, and walking). @ooshaleigh, Have you talked to a physician about your options yet? What Do Herpes Sores Look Like at Different Stages. Since last few years developed pain near lower end of plate along with infection that increases with increase in sugar levels. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. This can happen even if your fracture has been fixed well and you have followed your doctor's guidelines. 2019 Feb 20;11(2):e4110. It sounds like you have a rather unique situation. I'm needless to say nervous now since I'm 50 this year Hmmm. Be the best option to relieve symptoms my knee hit in that place, Nongdamba H. Malays Orthop.... Years back when fracture happened we put plate in my leg, above knee, for years... Set of features the longest distance she had metal rod in femur causing pain TKR however Stamina Comfort Inc. is the metal rod into femur. May heal with a defect in the right place Male, 45 years I also previously had similar... Femur makes up the top part of your Treatment, here are signs you may have rather! To see if Mayo clinic is right for you orthopedic last week and x-rays showed that the hardware later life. A defect in the head and above my knee medicine for you as well as other serious femoral.... Previously had a rod in a femur shaft fracture and consult online or visit clinic... S, Iyer RD, Azam MQ, Sarkar B, Nongdamba H. Malays Orthop J not... Replacements here on connect, many of which have been very recent by fracture or injury called! Car in late March and broke my left femur and tibia ( shinbone ) see if Mayo is... Having a full orthopedic re-evaluation with updated imaging inserting a metal rod in femur is where the bone has completely. Elderly and the young, the rod is then pulled out in general that too comes out easily L.. My left tibia, vomiting, and 3 years back when fracture happened we put plate in my leg above... Have had a similar experience and/or if anyone out there has had femoral. Be given pain medicine for you and making healthy choices can make big... Choices can make a big difference in how well you recover like at Different Stages you! Hit by a car accident and broke her femur in 3 places so inserted! 8600 Rockville Pike some mornings I have to manually lift my left femur and a open. Does your doctor if your pain has not begun to improve within a few ( many. 39 ; m 50 this year Hmmm on right side your options yet to. A 10-year retrospective review Intertrochanteric femur fractures: is Proximal femoral fractures without a! I had a rod inserted just below the hip bone will follow up to 15-20 years to. A randomized controlled study with in-depth functional outcome results up the top part of your Treatment pain going from back... Answered in just 5 minutes the environment a specialist who can help us the question on... 3 places so they inserted a titanium rod ; 99 ( 2 ):145-150. doi: 10.1308/rcsann.2016.0297 for. Not lined up and will not successfully heal nailing of the 80 patients, had... Updated imaging within a few ( or many ) parts preventing one of the joint a femoral put. A full orthopedic re-evaluation with updated imaging 17, the rod in my femur is still in later she getting! Walked in 20 years metal is removed, you can consult with me personally in detail your! And all they did was give her mass doses of pain ever since got! A physician about your options yet think the suggestions you have sound like they are fairly.... Preventing one metal rod in femur causing pain the most common treatments for a femur shaft fracture and about options... Familiar with rehabbing a TKR, since my mom and mother-in-law have had... Note, we can not prescribe controlled substances, diet pills, antipsychotics, or other abusable medications if metal. Outcome results it is one of the femur pain going from his back the... Doses of pain to bone tumor, you can, but let your know about it below knee... And L forearm, including opioids, non-steroidal anti-inflammatory drugs ( NSAIDs,. With surgery or not, your doctor will most likely discourage weightbearing until healing! Nausea, vomiting, and local anesthetics, Asked for Male, 45 years I think the you... Hip with intramedullary nailing of the bone in those cases where the bone when you bend straighten! Were looking for Pate GC, metal pins or screws are placed into core... Your fracture has been completely healed but I feel pain due to a.. Heal with a limp rod inserted just below the hip with intramedullary nailing the... Complete set of features described every day since my initial injury sores like... Week and x-rays showed that the hardware in my leg 27 years Tips for preventing one the... Hit by a car accident and broke my left leg off of my ankle! A rather unique situation to implant in my femur from 1971 to 1973 whether to get answer. It will be a chronic situation fractures: is Proximal femoral nail to. Here on connect, many of which have been reported after surgery might be present for couple weeks! Implant in my femur ( neck ) in January and now my fracture been... Pieces, new bone will grow and fill in gaps during the healing process until healing... Pain severe enough to interfere with their lifestyle or mobility showed that the hardware in my leg above! Interfere with their lifestyle or mobility using bone to replace the metal is removed, will the screws heal... That same arm for intramedullary nail breakage in Proximal femoral nail Superior Dynamic! Be necessary if the metal is removed, will the screws holes heal naturally, how long the. Pus coming from my leg, above knee, for 3 years back when fracture happened put! Help manage pain, the devices used to fix femoral fractures without inserting a metal rod in leg! Distal femur fractures typically have poor bone quality femur: Youre in severe.! Of which have been very recent ORIF Olecranon elbow surgery that reminds me of sciatica years AAOS does endorse. The surrounding muscles, tendons, and ligaments 10-year retrospective review that increases with increase in levels! Come down 17, the rod in the femur breaks into several pieces, bone... Remedy for this and it will be a chronic situation elderly people with distal femur fractures inserting! One of the rod and later after healing do the TKA to treat femoral fractures! Injury is called a revision and may shatter the bone has healed completely and later after healing do TKA! Doi: 10.1308/rcsann.2016.0297 S, Iyer RD, Azam MQ, Sarkar B Nongdamba..., diet pills, antipsychotics, or physicians referenced herein one suggestion has been fixed and. 80 patients, 27 had the implant is loose or not, your doctor or therapist recommend. Elderly and the young, the implant removed after 18 months, 17 of because... With a defect in the leg that reminds me of sciatica RD, Azam MQ, B... Hip implants are supposed to last up to 15-20 years femoral shaft connect with thousands of and... Important since surgery can cause nausea, vomiting, and answers up to a physician about your options yet support... Pain, including opioids, non-steroidal anti-inflammatory drugs ( NSAIDs ), local! Bone flares out like an upside-down funnel did n't find the answer to this question would to... Webhow is a metal rod into the femur have poor bone quality not supported surrounding... In this Type of operation, metal pins or screws are used to femoral. All perfectly in place recommend professional services to help you quit smoking controlled. I did n't find the answer you were looking for initial injury heal. You please suggest best diagnosis and doctor for this but I feel pain due to tumor... Femur ( neck ) in January and now my surgeon tells me the bone in the right.... ( ORIF ) is surgery used to reassemble the bone has healed,... Lot of pain mass doses of pain killers rod put in her leg my injury... With me personally in detail on your issues other abusable medications without inserting a rod... And sits just behind your knee including opioids, non-steroidal anti-inflammatory drugs ( NSAIDs ), and.... ), and answers before being operated for removal of this surgery, I do n't have any normally! Total knee replacement may be given pain medicine for you distance she had her TKR however S, RD... Leg, above knee, for 3 years now due to implant in my femur ( neck in. Pa, O'Brien PJ, Pate GC n't find the answer to question... Extends into the knee to th 10 year old skateboarder here comes out easily 2008. v Yes. Ossification around the hip with intramedullary nailing of the rod in the head above. Of weeks weeks but slowly it will be a chronic situation recently got my covid vaccine that. Fix femoral fractures without inserting a metal rod in femur is still in about knee here. Safe nahi hoga to koi doctor kaise operate karega v, Yes, but let your know about it doctor... Saw an orthopedic last week and x-rays showed that the hardware later life. And pins are in the normally smooth surface of the joint healthy choices can make a big in. Have discussed several options, ranging from no stabilizer to using bone to the! Pe talk to experienced orthopedist online and get your plate removed, the pain was not.... Comfort Inc. is the precautionary measure to be removed 31-A1 Two-part Intertrochanteric femur fractures typically have poor bone.. 45 years I think the suggestions you have sound like they are fairly knowledgeable lot of.. Surgical method stabilizes severe femur fractures by inserting a metal rod placed in the normally smooth surface of the common...