broken hip recovery advice needed...............

matt_n-2

I'm not really why I'm posting but I need to vent, open up a bit and share my worries.

My follow up X Ray, so 2 yrs and 2 weeks since my accident and they have picked up an area at the end of one of the screws which doesn't look so good. It looks a bit like a dull cavity on the picture and the Dr said it could be the bone dying off.

He looked at my 12 month and whilst there was a faint outline in the same place it's definitely darker now. On the other hand there was a dark area on that 12 month pic which has now gone so some bits seems worse, some better.

I'm really downbeat about the bad bit and I tend to look for the bad in situations anyway but going through all the pain and rehab again if I need a replacement is something I'm really not relishing.

I'm 34 with a 2 year old, I don't want to be in this position and am trying as best I can to not fret over it.

I made the mistake of googling avn and it doesn't look fun, femur head collapsing, crumbling bone and constant pain until I'm opened up again for a full or partial replacement.

As I said a bit of a ramble but I felt like I had to get my thoughts down.

pinno

Matt_N wrote:

I made the mistake of googling avn and it doesn't look fun, femur head collapsing, crumbling bone and constant pain until I'm opened up again for a full or partial replacement.

Well, they hoovered my left hip out but I still walked into hospital. Surgeon said it was on account of the fact that I kept cycling. I'm not sure the 'constant pain' bit is quite correct. I did have a walking stick but it never stopped me pedalling.

Would you rather the hip got to such a bad state that you became very immobile or would you rather get the op done sooner rather than later and get on with your life? Besides, one 2 year old at home with Daddy for a few weeks would be time to treasure (and some tricky tidying up jobs/nappy changes).

Has the Doc offered a THR and what's the time scale if you took up the offer?

sungod

Matt_N wrote:

...
I made the mistake of googling avn and it doesn't look fun, femur head collapsing, crumbling bone and constant pain until I'm opened up again for a full or partial replacement.

As I said a bit of a ramble but I felt like I had to get my thoughts down.

while in a&e they x-rayed me, i was told my hip was broken and i'd need an op, then immediately warned that there was a possibility a repair wouldn't last but that as i was fit, active and 'young' it was worth a try - i was mid-50s at the time - as having replacement now might mean two or more in future as they wore out

i had no idea why a repair might fail, and there wasn't much chance for discussion, it was maybe two hours from moment of impact to being zonked out in the operating theatre

with the aid of google, a few days later i'd learned more that i really wanted to about avn, this did nothing for my state of mind, but i got over worrying about it, and concentrated on the day i could ride again, that was a great day!

now i'm a couple of days off two years, next x-ray in july, it's still in my mind, but i avoid dwelling on it


bear in mind that most of what you'll find online about broken hips is probably based on people a lot older than you are

this article is a few years old now, but imho is good as it discusses the injury/outcome/options in younger patients...

https://www.ncbi.nlm.nih.gov/pmc/articl ... =printable

...you'll see there are other possibilities, and in the intervening years there could be improved/new options

stay positive, if it turns out you need further treatment, take control, you've got time to discuss the options and pros/cons, then you can make an informed decision

matt_n-2

At present the Dr doesn't seem too worried, I've got an appointment for 6 months time for another X Ray.

Mikey23

@matt-n ... yes it is a difficult and worrying situation. I was given the option but my odds were 40/60 against caused by the break being where it was, impacted and displaced. So pretty much a no brainer for me and im pleased with the outcome. The state of hip technology and for a young fit person these days is pretty good. Just read of someone playing squash after 5 months and 2 THRs which seems to me pretty remarkable. Whatever happens you will have an excellent quality of life...

pinno

2 THR's me and 1 complete revision. I'm doing fine BTW although I squeak when I walk and bemoan never having had grease nipples fitted... It just might be my @rse.

the_cyclist_of_catan

People got follow-up X-Rays? Lucky sods. I got discharged at six months (when the broken femur was still not completely healed). I want to go back and badger them to get the screws out of my knee, because 20 months on climbing a step is as hard as it was over a year ago - and has started to hurt more too

Still, I'm sure that everything will be fine so long as I never fall off again.

Traindriverrob

Hi people, I started reading this thread when I broke my hip in December '15 and I've not really been back until now. I'm a little concerned that some of you guys are having follow-ups, 2 years down the line. Is this in the U.K.? My last appointment was 6 weeks after the event and I've not been back since despite having a few niggles to this day. To be honest though, I've had it easy compared to some of you it would seem. I was doing 100 mile sportives 7 months post-op and I still enjoy hammering down the likes of Bike Park Wales.

LiamW

Traindriverrob wrote:

Hi people, I started reading this thread when I broke my hip in December '15 and I've not really been back until now. I'm a little concerned that some of you guys are having follow-ups, 2 years down the line. Is this in the U.K.? My last appointment was 6 weeks after the event and I've not been back since despite having a few niggles to this day. To be honest though, I've had it easy compared to some of you it would seem. I was doing 100 mile sportives 7 months post-op and I still enjoy hammering down the likes of Bike Park Wales.

I had my initial check up 6 weeks after my operation in 2013. My next appointment is in 2018 at some stage, no idea when.

matt_n-2

I've been back to the hospital - fracture clinic, as an outpatient every 6 months since my break.

LiamW

Matt_N wrote:

I've been back to the hospital - fracture clinic, as an outpatient every 6 months since my break.

Ah right, I had a full replacement in 2013. That's probably why I don't need to go back until 2018.

Spreader

First post - thank you to all previous posters of this thread. When I came out of surgery for my fractured femur I thought I must be the only person to have messed up so badly in life... this thread has been a lot of help.

I've been group riding, mountain biking (with some XC races) gravel riding/racing and and even done CX events. I've got a cargo bike for my kids and generally love cycling in all forms. 3 weeks ago I decided to ride across town to enter my first criterium race in the weekly series.

I entered even though no one else from my club was going that week, rode out alone and told people I was new and wanted to stay out of trouble. It was not a tight course compared to other races (so I've been told). The first few laps we were riding 40-50kph and it was thrilling. I heard someone calling a number plate. Wasn't sure if it was mine. The I remembered they place marshalls in the field and they coach newer riders when they can use it. Same number was called again and since I wasn't sure I looked back. Big, big, hard mistake. When I looked back forward my front spokes were "ting ting ting" off the derailleur in front of me. Before I knew it I was smashing into the ground and being pummelled by the rear end of the pack. Garmin shows I hit the deck at 43kph.

They triaged me on the race course, a most wonderful family doctor was in the race and stopped to help. Braced me and carried me off the live track and I stayed very still and very sore until the ambulance came. Placed on a Back board with a neck brace, ambulance tonEmerg for CT scan and x-rays. My wife showed up having picked up my bike and was there for the good/bad news. No concussion! Broken hip. It really broke me down. I've been to a chiro for months dealing with knee pain resulting from overworked hip muscles. Rode the trainer a bit in the winter, have club rides for cardio and races completed and more lined up for the summer. Plus cross is coming...

Surgeon offered me an option of immobilization for 6 weeks while it sets or surgery. I had surgery the next day and spent a total of 10 days in hospital.

Week 1 I couldn't really get out of bed or so anything. Started physio on day 3 or 4 and broke down at how pathetic I was at the exercises. Wife brought my two kids to see me ages 2 and 4. Luckily along with her visits I had friends, club cyclists and family come to visit me. My days were full of pills, vital sign monitoring and food. Of course Netflix and the data on my phone helped immensely. Time in the hospital really flew by. Near the end of my stay my back was really bothering me from being on it for so long. I made the decision to flatten out the bed and try to lay on the good side. Blessed relief! Painful painful relief haha

At two weeks I went for my first physio. Was strong enough to get around for short distances on crutches. Hopped a cab and took transit home after a walk down a main street. It was so nice to be out and amongst civilization again!! They gave me electrotherapy on my knee because of swelling and tested my range of motion. Modified and expanded my exercises and kept me working.

Had my stitches removed at 2.5 weeks and the doctor said no driving for another month. He also gave me an extremely low chance for AVN because I hadn't cracked the femoral neck rather just the outer top of the femur itself. Told me the hardware (DHS) would and should stay In for life.

Today Is 3 weeks since my crash. Sitting on a bench waiting for my 5th physio session. Going to go for a little walk after and look at a couple bikeshops for a new wheelset!

Trying to keep my chin and spirits up. It's a lot easier by all the great people in life. A phone call here, an email there, and a visit to watch them drink my beer when i can't is wonderful. I might even ask someone to put me on the back of my cargo bike and take me to the pub the club ride ends at

Mikey23

Did the Dartmoor Classic at the weekend. Only the piccolo route but I bleddy did it! Six months post op and life is getting back to normal. I'm riding as well as I was before the accident now which was something I didn't expect. Great to read these accounts...

pinno

Well done Mikey. What's on TV tonight?

the_cyclist_of_catan

There's a really good closed FaceBook group that a friend organises. She picks up a number of cyclists from a blog post out there by another unlucky sod who broke his femur on a bike.

The FB group is full of good advice and encouragement. Many of us are cyclists, snowboarders, horse riders or motorcyclists (who usually manage to REALLY mangle their legs when it goes wrong; a simple femur break is peanuts compared to what some of them do). The group is good for advice that the doctors forget to give you, and encouragement when things don't go quite to plan. Send me a PM and I'll get you an invite. Don't be discouraged by the under-30s posting stories of how they are walking at 6 weeks without any aids, and back to running/skiing etc at ten weeks. For most of us, those figures are months not weeks. First rule of the group - X-rays or it didn't happen!

It's pretty survivable though. It took me ten months to get back on the bike, but I did an imperial century on my "femurversary". Didn't really enjoy cycling for a good 18 months, though, as I remained terrified of what happens if I fall off with all that metalwork in the leg and hip. I've decided that I don't care anymore, though, so am enjoying it again. My muscles are a bit mangled by the break and the op, though, so I'm about 1-2mph slower than I was pre-break and just can't seem to get faster again.

GagalesGF

Good evening from Crete, Greece
I broke my hip on the 1st of September, had an operation the same day with two screws into my bone.
After 4 days left the hospital, not with a lot of pain but very disappointed.
Start working at home on the second week with a program from a therapist
and do some walking with crutches. First of November started swimming in a pool
and a week after start stationery biking.
On 26th of December I did my first ride on a street, with was a horrifying experience,
on January made my first big ride, 60 km, and gradually went to 13 hours and 165 km
with 2.500 meters accent, that was 45 days ago. All that time I was doing my physiotherapy
at home, about one hour each day, but I had great difficulty getting on and off the bike.
My therapist advised me to do stretching and balance training exercises, which not only solve
the problem of getting on and off from the bike, but also helped a lot to cure the Trendelenburg
gait and the limp.
Today, 8 months and 9 days after my accident, I had an X-rays test which show no signs of AVN
and finally got the license to run and trekking on mountains. I am 66 years of age, ex marathoner,
mountaineer and road cyclist. I must say that in this forum I found great support and advices,
but apart from doctors and therapist, you must listen your body and never loose your courage.

Many and happy kilometres to all of us
George

boxofrogs

Hi, New club member here. Broke my hip 04/08/18 so 1 week since surgery and have to say this thread has been a lifesaver, so thanks to everyone for sharing your stories, I’ve read them all. I had an absence seizure whilst remounting my bike and apparently fell heavily on my left side, smacking my hip against the kerb. Luckily a medic witnessed it and stayed with me, not allowing me to move til an ambulance arrived. On assessment they said I would need full hip replacement. X-ray showed it was an intracapsular fracture.

When I went for surgery the next day, the consultant explained it was a little tricky to see it properly via X-ray due to displacement so asked if I was up for having it done under epidural so he could talk to me and discuss the options once they’d opened me up, as he thought he might be able to fix it rather than replace it. He said a replacement was only likely to last 20 years and as I was still a relatively ‘young’ lady (just turned 63!) and with good fitness they wanted to get me mobile again as quickly as possible. I agreed and glad I did as he managed to fix it with a 2 hole DHS, although it was the most surreal experience of my life!

I was out of bed next day, walking with crutches, doing stairs the following and home the day after. It’s only 10 months since a car crash when I broke an ankle, 2 ribs and both bones in my arm, which took a lot longer to recover from. The injuries are all on the same side so feeling a bit bruised and a bit like robocop now with all this metalwork. I start physio this week and according to consultant should be able to get back on my bike in 6 weeks, although my sons are not too sure about that.

Like many others I found this thread doing some research and have found it really useful and also amusing - love the humour! Best wishes to you all and hopefully my experience may in turn help someone else.

sungod

well done, i asked to stay awake for my op but the surgeon wanted me out of it

toughest part i found was being on crutches soooooo long, i envy you the early physio

eat healthy, do what the doctors say, get on bike

harry-s

Well, I suppose I better add my name to this exclusive club...

Caught up in some pretty erratic riding in this years RL100 I went down heavily on the A4 flyover. Dislocated hip and snapped neck of femur, along with what the medics helpfully described as multiple injuries. The break was fixed with 3 100mm screws.

Almost 5 weeks on and I'm only able to walk very short distances, using crutches. I've a scan and x-ray scheduled in a couple of weeks, and hopefully this should give me the all clear to start a bit of physio. How successful this will be I'll find out, - there's a surprising amount of muscle wastage.

I've been a keen rider for many years, and have taken plenty falls and had a few breakages over that time, but now I'm in my sixties I'm thinking it might be time to hang my shoes up. I'm not sure I've got the stomach for another fall. Maybe the challenge of some uncomfortable physio will help change my outlook.

Chapeau to you lads back in the saddle.

pinno

Harry-S wrote:

I'm thinking it might be time to hang my shoes up.

No don't do that. Choose your routes and choose who you ride with.
It's early days and i'm sure you are feeling pretty rough. It is to start with but then the road beckons.

I have 2 replacements, i've also had a revision and now need a second revision but still go hell for leather down hills.
If I have a bad fall as a result which stops me cycling, at least I feel like i'm still living and not existing.

simonfr

Hello to everyone 'new' to the club. Keep you spirits up and you'll get through this like so many others here.

Its been over 7 years now, still cycling, and I rarely get any trouble with it now. Still have the metalwork in place as they wont remove it. No AVN or other complications (thank god).

Good luck to everyone.

PaulLCFC

Wow just the advice I'm looking for. I've not been on a bike for 20yrs after getting wiped out. Well last summer I part joined your club by breaking my hip. Been having a few problems aches and pains and a little limp. So last week I got full membership new bike and all the gear. Rode home from the lbs and been out twice more about 20 miles in total.

Already feeling a difference in my leg. So other that the obvious any other issues I need to watch for. Oh I'm loving the riding again anyone in great Yarmouth area want to do a week day ride?

PaulLCFC

Having read a little more are you all in the UK?

My break was July 5th last year op 9th kicked out 11th. No follow ups no physio offered my own Dr sorted that. I'm starting to feel left out.

sungod

follow up probably varies a lot according to exact injury and if it was repair or replace, i'd have thought there'd always be some though

fwiw after snapping the ball off right at the end i had repair, then two years follow up to check for any sign of avn (fortunately none)

arranged my own physio as none was offered and tbh after a bit of research i wanted to use iseh not the hospital physio, it was tough but it made a massive difference to recovery, both legs stronger than before, no limp

PaulLCFC

What is AVN? I snapped the ball of and was pined and plated.

sungod

avascular necrosis, if the blood supply to the bone is damaged too much then the affected bone eventually dies, it's not good

it can take a long time before the effects are apparent, hence the need for follow up over a long period

for me that meant returning to hospital multiple times over two years (with increasing periods between visits) for x-rays and assessment by the consultant, after the final visit there was no sign of avn, so at that point they finally discharged me

fwiw i think i was in the operating theatre within 2-3 hours of impact

much of the online info for broken hips is based on the old/sedentary, but when i was recovering i found this article which reviewed outcome for younger/active, might give you some perspective https://www.ncbi.nlm.nih.gov/pmc/articl ... rt=classic

harry-s

Thanks for the link sungod, it makes interesting reading, and usefully pulls together a lot of obs that are not easy to find.
I was interested to read about how prompt surgery should be, and that there is no conclusive guidance apart from “probably emergency”. It’s about 6 weeks since my surgery, so it’s a waiting game now. I’m pretty p*****d off with the RL100 organisers though. They talked a good talk about safety and medical support, but I was on the tarmac, in the rain, in central London, for almost 90 minutes. It wasn’t comfortable...
I’ll see how my local Nhs Physio goes once I get the nod. Iseh, is that a private physio?

pinno

AVN is not the problem per say. I had AVN in both hips. They were fine; the bone gets very hard. The problem is that when the bone became vascular once again, the become very soft and slowly disintegrate. If the process of vascularisation could have been retarded in me, they may have recovered.

AVN in normal people where there are no on going problems like arthritis or drugs (like steroids), immune problems in the equation, should not really be a concern. Only, if the circulation to the bone becomes compromised due to surgery, then it is an issue. I do not know how common that is.
FWIW, I was back on my bike within 6 weeks. Elderly people/people who lead sedentary lives take much longer to recover.

sungod

Harry-S wrote:

Thanks for the link sungod, it makes interesting reading, and usefully pulls together a lot of obs that are not easy to find.
I was interested to read about how prompt surgery should be, and that there is no conclusive guidance apart from “probably emergency”. It’s about 6 weeks since my surgery, so it’s a waiting game now. I’m pretty p*****d off with the RL100 organisers though. They talked a good talk about safety and medical support, but I was on the tarmac, in the rain, in central London, for almost 90 minutes. It wasn’t comfortable...
I’ll see how my local Nhs Physio goes once I get the nod. Iseh, is that a private physio?

it's... http://iseh.co.uk/patients/why-the-iseh

i went private but they do nhs via referral too

btw i wouldn't say it's a waiting game for recovery... they should have given you some exercises to regain/maintain mobilty to repeat 2-3 times every day, make sure your diet is high nutrient and you eat enough to support good healing - i'd expected to gain a lot of weight, but i probably ate more and in spite of reduced activity weight was pretty much the same, though i used to go for a hop around the park every day just to get some exercise

one thing i found the hard way is being on crutches does not make your arms stronger, i regret not doing some weights to maintain overall arm condition

pinno, when i was trying to find out about avn it seemed in hip injury the mechanisms varied, there're blood vessels that connect to the bone that can be damaged/destroyed, internal pressure could rise preventing circulation, and undoubtedly others i don't remember or never heard of, in that paper, the incidence of osteonecrosis is averaged across multiple studies at 23%

harry-s

Thanks for the ISEH link.
It looks just the job, and I'm definitely thinking of giving it a go, but at the moment at least, it would be a long cab ride to get there. How regularly did you visit them?
I think I've looked after diet and exercise as well as I can so far, and weight has stayed constant. Physio guidance has been restricted to sets of leg lifts, a walk round the park would probably be a tough call (although I'm not sure what the park/perimeter constant is...).
I've got a follow up with the consultant later this week, and an appointment with my local NHS Physio the day after, so I'll think a little bit more about what I want out of the next month or two then.
At the time of the op, the surgeon reckoned the chance of AVN was around 30%, so not too far from what the studies you found are saying. Interesting to see that in that paper that they seem keen to recommend very little load bearing. The NHS Physio was of the opinion that a some load bearing would promote blood flow and vessel repair, - so a difference in opinion there.
Good info sungod.