Cannulated Screw hip repair

General cycling advice ( NOT technical ! )
snibgo
Posts: 4604
Joined: 29 Jun 2010, 4:45am

Re: Cannulated Screw hip repair

Postby snibgo » 30 Sep 2012, 7:31pm

The consultant said that if I broke it again, I'd need a new hip. And it turns out I have osteoporosis which makes my bones liable to fracture. However, about four months after the fracture, I fell over quite badly on that hip. (I stepped off a step without realising it was a step.) It hurt a bit for a few days, but apparently didn't do any damage.

For me, the health benefits I get from cycling outweigh the potential harm.

okwithmydecay
Posts: 2
Joined: 26 Oct 2012, 11:28am

Re: Cannulated Screw hip repair

Postby okwithmydecay » 26 Oct 2012, 11:49am

Long time stalker of this thread but first time poster. I broke my femur in a rather freak and unspectacular fall whilst setting off on my bicycle, rounding a corner slowly, suddenly losing balance and landing directly on my side. Both myself and the doctors were very surprised I could break a hip from a such low impact fall at 32 years old but had been on prednisone for the year prior which can mess with your bone density.

I remember reading this thread lying in the hospital bed, waiting for my dynamic hip screw surgery, overwhelmed by the seriousness of the injury, being both optimistic of my recovery but scared of the complications.

That was four months ago and luckily feels like long time ago. At the three month mark the bone was declared healed and was back on the bicycle. I remember that first ride vividly, it had only meant to be a short cycle up and down the road but was turned into a 5mile jaunt. Since then I've been able to return to former levels of activity, averaging 25+ miles a day, perhaps with a little less power and speed.

Want to thank everyone that posted on this thread as some of the advice really helped. My advice is listen to your surgeon and physio, do all the exercises they say and then some. During my recovery and even now my friends say I over do it, but I always ran everything I did past the specialists. I could have got away with cycling probably much earlier but I was patient and waited for the bone to fully heal.

Still not out of the woods yet, got a slight limp still to lose and a lot of strength to recover, but I feel like I finally have my life back as can manage everything I did before the injury.

Si C
Posts: 8
Joined: 1 Sep 2012, 5:03am

Re: Cannulated Screw hip repair

Postby Si C » 25 Nov 2012, 8:15am

OKwithmydecay - Sorry to hear of your fall. You are really young to cop this inujury, but, my surgeon tells me he is seeing it more and more with cyclists.

I'm now 13 weeks post op. Things have been going well, apart from the gulf of difference in opinion between physio and consultant. The physio wants to push hard and the consultant is concerned I'm doing too much and pulls me back. I have now actually dropped the physio. I feel I'm paying 35 quid a week for this guy to just bend and pull my leg around with no effect. The benefit has come from doing loads of leg squats and light spins on the rack. I'm begining to think I don't need the physio anymore and it's just a regular pay day for him.

I have a limp, shortening in the damaged leg and restricted lateral movement. I'm sure that will improve with time, but certainly not back to what was considered normal. I also damaged my knee in the fall and am awaiting an MRI scan.

I'm just not sure about the future. Currently, I'm still in a bit of a feeling sorry for myself situation. My normal diet has gone out of the window and I'm boozing quite heavily. The result being that I'm unfit and now 9kgs heavier than my racing weight. I feel robbed of a pastime that I loved and for my age was pretty good at. The fear of riding on the road and falling or being knocked off is quite overwhelming. I just cannot afford to be in this situation again.

De Sisti
Posts: 740
Joined: 17 Jun 2007, 6:03pm

Re: Cannulated Screw hip repair

Postby De Sisti » 25 Nov 2012, 2:35pm

snibgo wrote:The consultant said that if I broke it again, I'd need a new hip.
For me, the health benefits I get from cycling outweigh the potential harm.

Did someone mention a new hip? I had some ironmongery inserted into my hip (resurfacing).
10 weeks post opand I'm walking without crutches although it still feels a bit stiff and sore
around the hip area. I've a couple of (very slow) bike rides without any complications.

I usually ride between 5k - 6k miles per year. Since the op (Sept 19) virtually no exercise.
My rehab is going to be slow and deliberate.

Asa Post
Posts: 2
Joined: 29 Nov 2012, 4:52pm

Re: Cannulated Screw hip repair

Postby Asa Post » 29 Nov 2012, 5:20pm

I was unfortunate enough to join this gang after a fall on ice on 18th November. There was some disagreement about the choice of treatment, as the surgeon felt that I was too old (60) for a repair, and didn't favour me returning to cycling because of the degree of flexing required in the hip when the pedal is at the 12 o'clock position. I managed to talk her round. Three cannulated screws, but no plate needed.
I'm currently on crutches, and have physiotherapy scheduled in a fortnight, and a fracture clinic visit in January. Currently no weight-bearing allowed. I live alone, so things have been.... interesting :)
I've learned a lot from reading this thread, which is easily the best I've come across in my search for information, so thanks to all previous sufferers for your comments and advice.

When I have something useful to add, I'll add it.

snibgo
Posts: 4604
Joined: 29 Jun 2010, 4:45am

Re: Cannulated Screw hip repair

Postby snibgo » 29 Nov 2012, 6:52pm

Welcome to the club, Asa and others. Sympathies to all.

Asa Post wrote:I live alone, so things have been.... interesting :)

Yup. All these things we take for granted suddenly become a major challenge. Like the time I figured out how to get a cup of coffee from the kitchen to the study upstairs. It involved putting the cup on a step, hopping up one step with the crutches, moving the cup up one step, take a rest, and keep going. By the time I got there the coffee was cold, but it was worth it.

Non-cyclists express surprise that I cycle with a dodgy hip. (Yes, it's still dodgy, two years on.) Truth is, it's the least painful way of getting around. The hip aches far less after an hour cycling than an hour of walking or driving. Even being the passenger in a car isn't great.

And if I don't get decent exercise, the hip gives me more trouble the next time I do. So I keep on going.

Asa Post
Posts: 2
Joined: 29 Nov 2012, 4:52pm

Re: Cannulated Screw hip repair

Postby Asa Post » 1 Dec 2012, 6:13pm

snibgo wrote:Yup. All these things we take for granted suddenly become a major challenge.


I managed to reach the toes of my bad leg today, so I can finally change my socks :oops: :D. Little victories are so pleasing.

okwithmydecay
Posts: 2
Joined: 26 Oct 2012, 11:28am

Re: Cannulated Screw hip repair

Postby okwithmydecay » 10 Dec 2012, 3:58pm

Si C wrote:OKwithmydecay - Sorry to hear of your fall. You are really young to cop this inujury, but, my surgeon tells me he is seeing it more and more with cyclists.


I've since had a bone density scan and looks like osteopenia could have made the fracture worse. Five months on and my leg is doing much better, recently returned from a trip of Holland where I managed rides of up to 35 miles per day.

pscomp
Posts: 2
Joined: 20 Dec 2012, 9:36am

Re: Cannulated Screw hip repair

Postby pscomp » 20 Dec 2012, 9:53am

Hi Guys,

I'm 44 years old and on 6th November I slipped and fell and broke the neck of my femur, I've fallen off my MTB many times and it had to be a stupid slip that did it !!! I was taken to the Bradford Royal infirmary where they operated and fitted 3 cannulated hip screws and 3 days later I was sent home with crutches and told non weight bearing for 6 weeks until I had seen the surgeon again. I went back this week for the follow up appointment and everything was good, I was told to start gradually putting more weight on over the next 6 weeks and a physio would visit me at home to give me the exercises. the surgeon told me I should be walking with 1 crutch by the end of the next 6 weeks.

I had no idea they take the screws out? I have a real problem sleeping on my right side as after about an hour the discomfort gets way too much.

I'm going to get my self a cycle trainer so I build my muscles back up and get walking as soon as I can.

Any advice from you fellow sufferers would be great

Thanks

Peter

goatwarden
Posts: 694
Joined: 20 Nov 2009, 12:03pm
Location: Bristol

Re: Cannulated Screw hip repair

Postby goatwarden » 20 Dec 2012, 1:21pm

I would ignore their advice to aim for use of a single crutch. This advice makes sense as a transition to someone who has never used crutches. In reality using a single crutch to bear any weight just makes you get into bad habits that make it harder to walk normally once you are fully weight bearing.

Much better to carry on using two crutches, thus maintaining symmetry and encouraging a normal gait. I would only advise using a single crutch as a “security blanket” (or mental crutch?) once you are fully weight bearing, if you need it; it can then act as a convenient resting perch and allow more convenient use of the empty hand. I used a walking stick in this role for a few weeks.

I had my screws removed after 13 months (I think I described the reasons and experience above in some detail). It has been fine, although it has not entirely removed discomfort in lying on my, previously broken, side. The scar remains a little sensitive and some of the muscle covering the area has never really come back, despite my endeavouring to live normally and use the leg fully.

A turbo trainer is a good idea; it really helped me in getting range of movement back. It also means that, on horrid days like today when paranoia about falling off and doing it again makes you not want to ride on the road, you can still get some exercise.

I would advise using an old bike on the trainer; weight is not an issue so no need for carbon wonders and I have never been terribly happy with the stresses put on the bike by use on a trainer so don’t trust my nice bikes to it.

pscomp
Posts: 2
Joined: 20 Dec 2012, 9:36am

Re: Cannulated Screw hip repair

Postby pscomp » 28 Dec 2012, 7:03pm

goatwarden wrote:Brickatius, you have my sympathies although I am glad you have got to a sustainable state even if it is dependant upon some bits you didn't grow yourself. Knowing how depressing I have found it all, despite it all being fairly straightforward for me so far, I can only imagine how I would have felt in your position.

I had my six month check last Wednesday. I was beginning to worry whether I was experiencing the beginnings of avascular necrosis, as I had started to feel a dull ache a lot of the time. I wouldn’t call it pain in as much as if I had to put up with it forever it wouldn’t really be a problem but worry because I haven’t really had any significant pain even immediately after the accident. However at the clinic they x-rayed me and told me there was no signs of whitening around the cartilage, so no indication of AVN. Great news; I put the ache down to the fact that I have been doing my first prolonged job since the accident for the last three weeks and it involved lifting a lot of timber and constant bending and kneeling.

The doctor I saw this time was not a hip specialist but told me all about the potential difficulties and risk factors for AVN. I then showed him a print of my "before" x-ray (don't know why he hadn't already seen the real thing) and told him it was not only badly displaced, but out for 20 hours before fixation and he suggested I was an ideal candidate for AVN and was surprised they had managed to fix the bone so accurately.

Encouraged by the prognosis, I asked if I was safe to ride a real bike yet (at six week check the consultant had advised me that a turbo was OK but not to ride a real bike for a year!). The doctor was somewhat illusory but came down to admitting they didn’t like to tell patients it was OK, in case they broke and blamed the clinic (fair enough in today’s world) but that I could probably ride if I wanted to. He suggested the issue was that the screws can present a stress raiser in the bone, so a potential source of fatigue failure when subjected to repeated stress cycles; this did make me wonder why they suggest using a turbo is fine as that would still cause the stress cycles.

On the strength of this advice, today I rode the five miles round trip to the Post Office and enjoyed it greatly. Hopefully tomorrow we will get to take our first ride on the new tandem which has been sitting idle in the garage since collecting it in February.


I was the same as you, badly displaced and 20 hours before fixation so I'm hoping to avoid AVN. I'm 8 weeks in and at the 6 week checkup everything had lined up and was healing well, I can apply a lot of weight to the leg but I'm not going to push it and try and walk just yet.

DerekJ
Posts: 3
Joined: 1 Jun 2016, 3:35pm

Re: Cannulated Screw hip repair

Postby DerekJ » 1 Jun 2016, 3:52pm

I am a 55 year old male and broke my femoral head falling off my bike. It was a displaced intracapsular fracture and the surgeon wanted to do a total hip replacement. I said no, so they pinned it with 3 cannulated screw instead.

After one week I started exercising with the stationary bike, no resistance, purely for the range of motion. At 3 weeks I added some slight resistance. They advised toe touching only for 6 weeks, but I heel touched being careful not to put weight through the leg. I am glad I did this as I retain a good range of motion.

Weeks 6 to 12 were 50% weight bearing, which I mostly adhered to
although the stationary bike became progressively more aggressive. Had four very useful hydrotherapy sessions during this period.

At 16 weeks I was walking a good 5 miles over very hilly terrain, so things were going very well.

It's now six and a half months after the injury and last week I had the screws removed, which is quite early according to the accounts I've read.
But I got them removed as they were causing pain and I felt the chance of necrosis would be reduced.

Still quite sore, some pain in the groin area and walking quite slowly!

With this sort of injury the recovery is very individual and usually quite long. You need to listen to your body and consider the medical advice. There is no one size fits all. Good luck to anyone in recovery. It's not pleasant!

Richard D
Posts: 224
Joined: 27 Sep 2011, 6:16pm

Re: Cannulated Screw hip repair

Postby Richard D » 9 Jun 2016, 8:39pm

Similar sort of story with my subtrochanteric spiral femur fracture (fixed with IM nail with two big lag bolts into the femoral head), only with a longer recovery time and sod all chance of persuading the surgeon to extract any of the metalwork. I was off the bike for nearly ten months, but in two weeks time it'll be exactly a year and I'm planning on doing the 160k ride that did for me last summer.

DerekJ
Posts: 3
Joined: 1 Jun 2016, 3:35pm

Re: Cannulated Screw hip repair

Postby DerekJ » 11 Jun 2016, 12:40pm

Richard D, good luck with your 160K ride.

I decided to pay privately to get the metalwork out as it would have taken ages on the NHS, although they did agree to take it out but I
could not face the frustration of a long wait and a series of cancelled operations.

Turns out I've got osteoporosis. The figures are quite impressive :-(
Not going to let it stop me getting back on the bike, though.

TimB
Posts: 1
Joined: 29 Aug 2016, 9:35pm

Re: Cannulated Screw hip repair

Postby TimB » 29 Aug 2016, 9:41pm

Just got back on the turbo trainer 8 weeks after having a DHS installed after a low speed tumble on a greasy road half a mile from home. At the moment just 10 mins spinning to get the mobility back into the joint. Hopefully my next appointment at end of September will see me full weight bearing.