Cannulated Screw hip repair

General cycling advice ( NOT technical ! )
goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 10 Dec 2010, 9:18am

I finally got to see a (private) physio on Wednesday. I was disappointed, though not surprised, to find that the muscles on the outside of my thigh (through which they had gone to fix the bone) had shrunk longitudinally and circumferentially.

I have only about one quarter of the bend in my knee which I had normally. This is less than I had when I left hospital and has reduced due to my leaving the muscles inactive for fear of causing further damage to the hip. Had the physios at the hospital given me any useful advice, I would have understood that I could do no harm by exercising those muscles, could have retained the stretch and thus the bend. As it is I now have a long (painful) way to go before I have enough bend to pedal a bike, let alone getting back to normal. However I do have some exercises to follow and at least feel that I am improving rather than declining.

To anyone else who has this injury I recommend harassing the physio to get an exercise plan from the very start. If nothing is forthcoming then p.m. me and I would be very happy to send scans of my sheets.

xpc316e
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Location: Bury St Edmunds, UK

Re: Cannulated Screw hip repair

Postby xpc316e » 10 Dec 2010, 7:46pm

No advice to offer you, but I am sorry to hear of your nasty injury and I hope that you are soon well.

I think that you did the right thing in trying to get out of hospital as early as possible. They are horrible places, full of ill, infected, people. It is usually impossible to get a decent night's sleep, and the food is dire. Well done for escaping at such an early stage in your captivity.
Riding a Dahon Jetstream P9 folder, a Decathlon Fitness 3 flat-barred road bike, a Claud Butler Cape Wrath MTB, a TW 'bents trike, a Moulton-based tandem, a Scott CR1 Comp, and the latest acquisition, a custom-built SWB, above seat steered recumbent.

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 6 Jan 2011, 11:18am

I went for my six week check-up just before new year, at my local hospital, so with a consultant who actually spoke to me. He told me cycling on a static bike would be good, once I am weight bearing, but advised me to forget about real cycling for a year! Thanks! Meanwhile, in the real world I will just do what seems sensible.

He also warned me about the possibility of avascular necrosis, whereby the ball of my hip could die through loss of blood supply (it appears that, whilst wielding their battery drill within my leg, they didn't bother looking to see whether my accident, or their tools, had detached the blood vesseles supplying this part of the bone). If this happens, it will hurt like hell and the only solution is hip replacement; they last ten years at best and you can have three if you are lucky, so that would give me up to 75 at best; activity wears them out quicker!

Floyd Landis won the 2006 TDF on a hip with severe avascular necrosis and had it resurfaced (newer, slightly less destructive alternative to hip replacement) shortly after. I find it strange that he was unable to hide his doping disqualification behind a doctor's not, since he must have been having cautizone at least to relive the pain. I believe there were several other positive tests in that event which went unreported as the riders had doctor's approval for their nefarious guzzling of narcotics.

snibgo
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Joined: 29 Jun 2010, 4:45am

Re: Cannulated Screw hip repair

Postby snibgo » 6 Jan 2011, 11:59am

Sorry to hear your news.

My physio made a point of saying she was NOT recommending that I cycle. However, she was curious to know how I would attach the crutches to the bike.

I cycled the 41-mile round trip to my 18-week fracture clinic.

Then the cold weather arrived, and one day I spent a couple of hours waiting for buses. Pain arrived that day, and stayed when I put any weight on that leg throughout the cold weather when I couldn't exercise properly. I feared the bone had died. However, I have now spent a few days exercising (walking), and the pain is subsiding.

So I think (hope) my pain is purely muscular, not bone. The pain occurs only when I walk, not when I cycle.

You should NOT take any of this as a suggestion to go against medical advice.

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531colin
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Location: North Yorkshire

Re: Cannulated Screw hip repair

Postby 531colin » 6 Jan 2011, 9:24pm

I once took a lad with cerebral palsy out on a tandem for several hours. Poor old Norman's legs aren't up to much, so we figured we should take his crutches, so he (we) could walk up any hills we couldn't ride up - Norman can only do a few paces without crutches.
I tied Norm's crutches to the tandem crossbar with toestraps. I figured I should keep the crutches away from Norm's knees, as I have more control over where my knees actually go than he has, so even on the tandem there was a fair length of crutches sticking out the front.
It all worked fine, except............its wonderfully disconcerting when you turn the handlebars and a big chunk of "bike" in front of you carries on pointing straight ahead!

We came to a park bench for a breather, so Norm heaved himself off the bike and did his ungainly shuffle to sit down, much to the concern of the woman already sat there. I then said "He was fine before we set off" or words to that effect..........unfortunately Norm cracked out laughing and gave the game away!

Sorry, bit OT, but happy days!

Solitaire
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Re: Cannulated Screw hip repair

Postby Solitaire » 7 Jan 2011, 5:40pm

I went for my 6 week Xray and check yesterday. This entailed a 160 mile round trip and an expensive night in a hotel due to threatening blizzards. I waited 2 hours for a 3 minute consultaion during which my consultant prodded my "wound", gave what appeared to be a cursory look at my Xrays and told me that I could begin to weight bear gradually on the bad leg. The only important question I had time to ask him was could I use the exercise bike and the answer was YES!

I felt as if I'd been abandoned, especially as my one appointment with the NHS physio was cancelled due to snow before Christmas, so I phoned my GP this morning who advised no more than 5 minutes on the bike at the lowest setting for the first week. Well, it's a start. I'm unlikely to see a physio for a couple of weeks, so I then phoned the hip fracture nurse at the hospital who at last was able to reassure me and give some much needed advice. I can now weight bear, but still use crutches for stability (it feels wierd, but certainly eases the pressure on hands and good leg) and she confirmed that the static bike was a good idea, but a road bike was "some considerable time away". Didn't dare ask how long.

So at last I can get the juices flowing to aid recovery, and maybe warm up my permanently cold left leg. I think that the moral of these stories is that you have to push the NHS to get the service you expect. If you take a passive stance you will get good basic care when in hospital but you feel cast adrift afterwards unless you are prepared to agitate. This has certainly been confirmed by previous brushes with the NHS, but does mean you have to overcome the natural tendency to avoid making a nuisance of oneself.

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531colin
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Re: Cannulated Screw hip repair

Postby 531colin » 7 Jan 2011, 8:31pm

I took a friend for his consultant appointment.
I stood between the consultant and the cubicle curtain (the exit) so the consultant couldn't leave until I was sure my friends questions were answered and the answers understood.
The consultant was a bit surprised, but in the end I think he appreciated the patient and me taking an interest in the treatment.
Those are the patients who get the best recovery, in the end, thats what counts.

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 18 Mar 2011, 7:28pm

I thought I would revisit this thread in the hope of getting some reassurance, or otherwise, as to how I am doing at present. I would be grateful to hear comparative experience from anyone who is further along than me.

I am now 17 weeks from my accident and feel like I have stopped progressing, or am even regressing. I have followed all medical advice and only done activities when advised it was OK. Up until a week or two ago I felt I was making steady progress. However now I am back to swimming up to two miles at a pace not far off my previous and can happily do 30 minutes at 80 - 90 r.p.m, with a 76 inch gear on my turbo (doc told me static bike was good but keep off riding on the road), so am feeling fairly fit. However I still limp when walking and can't do stairs smoothly on both legs yet. More worryingly I am "aware" of the joint most of the time with sensitivity a bit like a minor bruise on the outside of my thigh, around the scar, and a mild dull ache from the area of the joint itself. I also have some pain when trying to rotate my thigh outwards (I still don't have confidence to put on trousers by stepping in with the good leg, so balancing on the broken one. My overall impression is that it doesn't feel (in the sense of discomfort and awareness of that joint above any of my others) any different to how it did at six weeks, even though I am much more mobile and back to normal in most respects.

I hope that this is all pretty normal and I am worrying about nothing, but I am not due to see the doc again for a couple of months and have no other source of comparison. I would be very grateful to hear of others’ experience at this stage. I would love to talk to Floyd Landis, or that Astronaut, but can’t seem to fid their details…

snibgo
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Re: Cannulated Screw hip repair

Postby snibgo » 18 Mar 2011, 8:02pm

Hi, gw. Good to hear you are doing fine.

And you are doing fine. I think minor ups and downs are normal. Not that I'm a medic or anything, but compared to me, I'd say you are doing wonderfully.

At 17 weeks I was still on crutches. When I came off them a week later, I didn't walk with a limp so much as like a lop-sided penguin. There was pain when I put weight on the bad leg, much as you describe. The joint moved well, and I could cycle fine, but walking wasn't at all easy.

I did plenty of walking and cycling, getting better at each, but the pain remained. I feared it might be bone death.

Now I'm at 32 weeks. The physio recently gave me new exercises. See http://cycleseven.org/exercising (including the comments), and they are making a big difference. The hip is now mostly pain-free, and I walk without a limp.

I can't yet walk for a long distance. Half a mile is my limit before needing to rest the joint. But I'll get there, I'm sure.

My advice: a physio can probably identify muscles that cause you problems, and prescribe suitable exercises.

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 19 Mar 2011, 5:50pm

Thanks Snibgo, that is all very reassuring. I think my main problem is that this is the first real physical problem I have had in my proper adult life and it is all rather strange; so to only get any feedback at ever increasing intervals from a brief chat with someone I have never met before, who has seen my X-ray from that day and none of my history, is all a bit unhelpful. To hear from the experience of somebody farther along the same journey really helps. In fact today we have been out for about five miles in the beatiful sunshine with a friend's dog and I am feeling really good; walking over rough ground tends to mask my limp and so I feel less conscious of it.

94inchandy
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Re: Cannulated Screw hip repair

Postby 94inchandy » 19 Mar 2011, 6:50pm

i broke my femur in 6 places, i had a IM nail, i was back on the bike in 3 days (turdo) it took a good 6 month to get the power back. get a sports physio via the NHS, if poss have the steelwork taken out, ok it a little painful, this means if you do come off it only broken bones not bent steel

snibgo
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Re: Cannulated Screw hip repair

Postby snibgo » 19 Mar 2011, 6:52pm

Sunshine always helps, doesn't it?

Something else I might mention: in early February, I accidentally tested the strength of my repaired hip.

I was walking along a footpath, didn't see the step down, and fell like a proverbial tree on my side. The hip took most of the impact, the shoulder took a little, and this time I tapped my head (still wearing the bike helmet) on the path. It was a repeat of the original accident but without the bike.

The hip hurt just as in the original accident but this time the pain reduced over the next 30 minutes instead of getting worse. Phew. I didn't go to hospital and (as far as I know) didn't do any damage. The repaired hip seems as strong as, or possibly stronger than, before.

I don't recommend that others test their hips in this way. And I don't claim the helmet saved my life.

goatwarden
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Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 19 Mar 2011, 7:46pm

My sympathies but funny story. It has struck me all along that , in addition to any bone fusion, my femur has got three pieces of stainless steel reinforcing it, so should put up with a bit of punishment; this didn't really reassure me when my crutch slipped in the cold weather (at around five weeks from my accident) and my bust leg ended up taking well over half my weight with shock loading.

I didn't bang my head in my original accident and the fact that my helmet was devoid of any scratches was the only way I could ultimately convince the ambulance girls and the A&E massive that I was unscathed by head injury.

Teddylegs
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Re: Cannulated Screw hip repair

Postby Teddylegs » 22 Mar 2011, 8:16pm

Dear all,
It has been really good to read about the experiences of fellow cyclists and hip-busters!
I had a lovely last bike ride on Friday the 18th of February - but by the following afternoon, I had fallen ( wet kitchen floor) with the full force of my body and broken my left neck of my femur. As I landed, I still had a tea mug in each hand - so I had no time to break the fall. They operated 13 hours after the accident (limited use of the theatres after 8pm on weekends) and I ended up with 2 cannulated hip screws.
As others have said - it is usually an 'old person's injury' and I really felt for the very old ladies that I was incarcerated with - because nursing staff spoke to them as if they were little children.
I was only 53 at the time of the accident - getting out 9 days later - on my 54th birthday. I appreciated the skills of the doctors and surgeons - but I hated every minute spent in hospital.
I saw my consultant after 4 weeks - and it seems that the metalwork has moved a bit - but 'don't panic at this stage'... If the bone does eventually mend together it won't be exactly in line - but apparently it shouldn't make too much difference.
The upshot is that I have another 4 weeks without weight-bearing and just hope that it heals in the end.
Like other posters, I have begun to wonder when I will get physio. Less than two years ago I had lots of physio sessions prescribed by my GP for Plantar Fasciitis - which is horrible -but really seems a minor inconvenience compared to the helplessness I feel with my newly-broken hip! The suggestions for exercises posted on this site look really good and I will be having a go over the next few days - so good luck to you all and happy healing!

snibgo
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Re: Cannulated Screw hip repair

Postby snibgo » 23 Mar 2011, 12:15am

Bad luck, Teddylegs. Get well soon.

To get proper mobility as soon as possible, I think it's really important to get a physio. Bash your GP over the head with your crutches until you get one. And then, of course, do the exercises.