Cannulated Screw hip repair

General cycling advice ( NOT technical ! )
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Re: Cannulated Screw hip repair

Postby liffy99 » 25 Oct 2017, 8:00am

What a great discussion thread, albeit for mostly younger peeps than I.
Eight months ago I broke my neck of femur ( complete, displaced fracture) and had the bone screwed together with three cannulated screws. I had lost 1cm of femur length. The operation seemed to go well and the recovery over the first three or four months progressed slowly. By the end of four months I had lost the crutches and was walking up and down Glastonbury Tor to try and regain muscle strength etc.
However over the past few months the pain and discomfort has steadily increased and I find it extremely difficult with any twisting or turning movement. Getting in and out of a car, a seat, twisting and turning are all a challenge. Putting my left sock on is becoming impossible.
Consequent X-ray and MRI scan have shown that the bone has shortened whilst healing (so I have now lost at least 2cm) and alignment at the hip joint is not good (sorry, I can’t recall the name of the angle betwixt pelvis and femur, but it’s more of a right angle than a smooth curve like it should be). The shortening has meant that one screw head protrudes more than it did and I have a lot of inflammation around the whole area.
Next step is to have an anaesthetic injection into the hip joint as part relief, part diagnostic - if I can then mobilise with far less discomfort the problem is the hip, if not the problem lies elsewhere.
The consultant seems pretty sure the hip joint is the problem and that I will probably need a hip replacement. At 61 though it is disappointingly early as I would need another when I reach my mid seventies.
But I struggle to understand why the bone has shortened whilst healing and why the operation was seen as a success if the X-ray post-op clearly showed poor alignment.
In the meantime I want to try to replace some muscle wastage ( there is a quite marked difference now between left and right leg) - an indoor cycle would be good - any suggestions ? I have tried my touring bike with a turbo trainer but cannot straddle the crossbar.
I am not a competitive cyclist but just tour and commute. This year I retired early with a view to cycling across France but two weeks after handing in my notice, I broke my leg - what a start.

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Re: Cannulated Screw hip repair

Postby Vorpal » 25 Oct 2017, 9:35am

I suggest talking to your medical professional, but I don't see any reason that you cannot use an indoor trainer, or even cycle. One thing to be cautious about is that many medical professionals are not familiar with cycling. A physio, or sports physio might be more help, as long as they are aware of the history of your injury.

I know three people who cycle despite difficulties with their legs and/or hips; one had a severe injury to his leg and hip, and has limited use of his leg for walking, but he cycles well, and says it helps his hip and lower back problems. Another has MS and one leg that is substantially shorter than the other. She has a special shoe that she wears with a platform on her short leg, but cycling is her main form of transport. The third person only has one leg. He carries crutches on his bike.

It might be worth using a platform on the pedal for the short leg to help your hip alignment.

Another exercise that you might be able to manage is a rowing machine. If you needed it, it would be quite easy to stick a book or plank on one foot rest to accomodate the shorter leg.
“In some ways, it is easier to be a dissident, for then one is without responsibility.”
― Nelson Mandela, Long Walk to Freedom

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Re: Cannulated Screw hip repair

Postby DerekJ » 14 Apr 2019, 1:42pm

Hi liffy99,
This reply to your post is well late, but I've only just read what you posted.

Like you, I had three screws in the head of my femur and the recovery seemed to go well at first. But I too lost about 2cm of length and one of the screws was very dangerously close to poking through the end of the bone. I had the screws removed, hoping things would improve but they did not. And an MRI scan revealed that the head if the femur was dying. All this followed a bike accident when I was 55, so I finally go a hip replacement at age 56.

Was worried about its longevity, but the ceramic on ceramic are much better these days and could well last many decades - no one really knows as the longevity data on the new replacement obviously does not exist yet.

I paid privately to get exactly the replacement I wanted, but I could have got the same on the NHS, with the same surgeon, but would have had to wait three months longer.

More than two and a half years on, things are still going fine.

One factor that worsened the shortening was that it turned out I have osteoporosis.

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Re: Cannulated Screw hip repair

Postby devonboy » 15 Apr 2019, 10:13am

Last June I was knocked off my bike by a jogger and fractured the neck of my femur about 3/4 through.Initially they wanted to give me a replacement hip (at 69 I am apparently geriatric and that is the policy) but after a robust exchange this was changed to a three screw repair.

I discharged myself after one day and was left home alone for the next 6 weeks.I got no help from my surgery ("we have neither the budget or the resources to offer physiotherapy")This left me with the internet to provide exercises to work through but also led me to a site with a new twist on post operative care.Essentially the theory was that that 78% of patients feel little or no pain after the operation so these were cored out and and asked to progressively load more weight onto the injured leg.The subplot was that this also aided in the formation of new bone cells.On average their patients were walking without support in 4-6 weeks.In my case I was walking after 5 weeks and ended up trotting into my 6 week review holding my zimmer in my hand,which was promptly confiscated by the aggrieved surgeon who had performed the operation.

I lost remarkably little fitness or muscle mass due to the constant exercise but suffered a massive loss of confidence,so in August I bought a recumbent trike from KMX figuring that I could neither fall nor be knocked off while on three wheels,which has proved correct.This got me out and about and eventually in January I bought a mountain bike and I use this on long slow runs away from the main cycle tracks and roads.This a far cry from my CF Roubaix which I sold but better than nothing.

Physically the bone has healed well with no signs of necrosis or arthritis(two xrays so far).I had problems bending the affected leg at the hip and could not put my sock on or cut my nails until this month when things have finally started getting better in this respect.I get the occasional ache over the operation site which goes away with exercise,which my chiropractor suggests is muscle inflamation as it rubs over the screws and plate.Bottom line is that this is a major injury which will take a long time to heal.I also think that I was lucky in that my bone did not fracture right through which means that my leg is the correct length and there was still a blood supply to the femur after the accident.

Good luck with your recovery.

Jos Ann
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Re: Cannulated Screw hip repair

Postby Jos Ann » 2 Aug 2019, 11:33pm

I am Jos A nn and I m 47 yrs old. I had a fall 5 months ago and was operated on the same day. 3 cannulated screws were inseted in my hip to repair the fracture. I was non weigh bearing for 3 and a half months as I had a bit of dislocation and the surgeon told me to not bear any weigh. Finally after my last visit and xray the surgeon told me that fracture is healing well and to start weigh bearing with physio. The physiotherapist told me I I m doing fine and 10 days ago I started using only one crutch.Now the problem is that when i am finding it hard when i stand up from a sitting position. I feel that my injured leg is extremly heavy. I have to make a huge effort when i take the first few steps after the sitting position. Then it is ok, afterwards i walk jusr fine with one crutch. Has someone experienced the same thing pls as I am worrying.I would like to hear if someone had the same experience and share it.
I would also like to have the screws removed once the fracture is completely healed as I find discomfort while sleeping and make certain movements. Hope all of you are bettter now.

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Re: Cannulated Screw hip repair

Postby devonboy » 4 Aug 2019, 9:11am

Sounds a little like my experience.Sitting down for so long is not natural and you lose muscular strength and tone which translates into weakness as you try to get moving.

It all resolves with time and effort,since getting on my trike last August and buying my MTB in January my bike computer is telling me that I am coming up to 3000 miles split between the two.Currently bouncing like an Easter Bunny and feeling good.

I am also going to be requesting screw removal as I do still feel an ache over the operation site after a period of inactivity which goes away when I start cycling,suggesting inflammation caused by the muscle rubbing on the hardware.

Good luck