Cannulated Screw hip repair

[andy63]

Hi sorry to hear about your accident hope you are recovering well .
In June last year I was hit by a van , which result in me fracturing my femur . I had a dynamic hip screw repair . Not sure it's the same as you have .
I was told to partial weight bear after two weeks , I think .
Any way I had physio etc and went back to work in January and am now back riding , but not as much as before yet !!!
My physio said I have a lot of muscle wastage and still not back to full strength .
If you want to compare notes feel free to pm me .
Andy

[markowe]

Well, I don't think I posted on the thread at the time of my injury, but I certainly read it avidly, so here is a potted account now, 8 months on:

- stupid fall (aren't they all) in an XCM race July 2011
- 3 cannulated screws in the hip, you're lucky you're young (38), bla bla
- 6 days in hospital post-op, physio started straight away
- about 3 weeks later, a call to spend 3 weeks in a special physio rehab ward (yes, standard practice for hip patients here in Eastern Europe - long live Socialist medical systems!). Boring static physio twice a day for all three weeks, but must have done a LOT of good.
- 1 month in, surgeon says 20% weight bearing, ARGH! Only 20%!? I thought we were nearly done!
- 2 months - 70% (kill me someone)
- 2.5 months 100% (3rd check-up w/surgeon) - FINALLY! Was on crutches ALL this time, went crazy. Literally just ditched them the second I walked out of the clinic!
- 3 months - got back in the gym and started winter training Surgeon just said, take it easy, no heavy weight-bearing exercises (yeah, he was thinking more along the lines of swimming but, God, just not swimming..!!).

3 months after that (January this year - 2012), I went for another check-up with the surgeon who saw everything was still in place and said, "See you in a year's time". Now, I was rather hoping he was going to agree to take the screws out. I should have read this thread more carefully to save disappointment. "No way", he said, "Don't count on having them out in less than two years post-op" ARGH!!!

2 months after that, and lots of hours in the gym on the trainer, even loosely following the Friel program, I FINALLY got on the bike again, with some padding in the hip area! And no SPDs, just can't risk an unbroken fall. Some great rides in the hills, taking advantage of 25c days in March, awesome. Riding the descents veeeery carefully though.

Several bouts of minor pain (the first since the op) in recent weeks, in the joint and/or around where the screws stick out - got worried, till I realised it coincided EXACTLY with several abrupt changes in weather Oh man, I am a walking barometer! It's all just fine now.

Well, here's where I am at the moment - I really think the surgery was a total success, it's all set great (my surgeon's colleague commented on what a good job it was, on looking at my X-ray in passing!) I have also got back into fitness to a degree I honestly didn't think would be possible. I actually even think I could give some of my Masters pedalling-mates a run for their money if I did a race now. There IS a little limitation of my movements, I am pretty sure entirely due to the screws - especially if I cross my legs, that kind of thing, is a bit uncomfortable, but there is NO restriction when I am cycling, unless I really start putting a lot of weight on it, and that might be more psychological than anything else.

But it's the screws... The surgeon told me (as someone else in this thread was told, I think) that if I had a similar accident again with the screws in (or possibly he meant even AFTER they are removed) I could forget about having a similar procedure again - it would be an artificial hip for me, so, as he put it, you decide what you prefer. So the frustration is, I feel great and could get right back into racing and stuff, but I just can't risk it, at least not until the screws come out, if they ever do. Still it IS good to be back on the bike, in the woods! Just wish I could, well, RISK a bit more, you know...

Anyway, hope my little account helps someone. Physio is VERY important, I guess, is the big message.

[snibgo]

Thanks for that, markowe.

"3 weeks in a special physio rehab ward" -- wow. May I ask, what country is that? Far more thorough than a physio visiting me at home a few times.

In hindsight, I didn't do anything near enough exercise to keep a decent strength, but I'm not sure how that would be possible without straining the joint. I reckon it took me one year post-fracture to get back my full strength.

[markowe]

Thanks for that, markowe.

"3 weeks in a special physio rehab ward" -- wow. May I ask, what country is that? Far more thorough than a physio visiting me at home a few times.

In hindsight, I didn't do anything near enough exercise to keep a decent strength, but I'm not sure how that would be possible without straining the joint. I reckon it took me one year post-fracture to get back my full strength.

Yeah, I'm in Serbia - the Eastern Bloc took (and still take) their physio very seriously!

There was an in-ward physio who visited me straight after the op and immediately got me trying to do leg-lifts and bends (very hard with such a swollen, painful leg, as you can appreciate). Then she told me to keep doing those at home until I got the call to go into the physio ward, which I did, and I think it really helped get the blood flowing and recover/maintain flexibility. You do have to push the pain barrier a little...

The physio ward, once I went in there, was mostly populated by older ladies post-hip replacement, though there were a few of us younger types who had suffered youthful misadventures of one sort or another (not just hip breakages) plus a few post-amputees too. I should point out these were all non-weight bearing exercises - isometric-type, leg-raises basically, but exercising various muscles. The physio basically just showed us how to do them correctly, and then you just go through them, in a kind of gym-hall, with beds, with about 7 or 8 people, and the physio just keeps an eye on you to make sure you are doing it properly. Because I was non-weight bearing all that time they couldn't actually give me any new exercises, so it got pretty dull..! Anyway, just giving you an idea of how that looks.

Yes, keeping up strength without straining the joint, or causing a break at the stress-points, always a worry, I would say my strength is my "weak point" as it were - my fitness level is very good, but I have gone easy with those "force/endurance" type bike exercises where you pedal uphill in a high gear, or stand out of the seat and do really steep climbs. As soon as I feel I am putting too much pressure on, I dismount. As I said, the exercise I was doing in physio was isometric, so basically you can apply strength without risking damage as you are not bearing weight - you basically cannot apply enough weight just lifting your leg to cause damage, but you are still keeping basic strength up. I am sure it DID help, but it has to be said that until I started walking and biking again, my injured leg didn't recover its muscle mass, it was visibly thinner than the other leg.

Well, hope things are still on the mend for you! Let's be careful out there!

[Teddylegs]

I am most envious that you have your screws back. I hope you will find a good use to put them to; I may have mentioned above that there may still be a door in my old house secured with a beautiful stainless steel woodscrew which previously spent a year or two in a friend's tibia.

When I went for my six week check-up, my screw holes were still pretty visible on the X-ray; he didn't really give any reliable period for them to fill-in completely. He told me I was OK to run again if I wanted but to avoid jumping off buildings for six months.

Hi Goatwarden,
'Avoid jumping off buildings' - I love it!
Blimey - you were offered further X Rays after the operation! I was told to only make an appointment to see the surgeon 'if I was worried' and just to use my walking stick when outdoors just for a couple of months.
I think I should make an appointment because I'd really like to see how far things have progressed bone-wise.
Re getting the screws back, mine are titanium- and I have since found out (from a medic in the family) that 'throwing the screws away' is a cover story. The truth is that the titanium is too expensive not to sterilise and recycle.

[Teddylegs]

I am most envious that you have your screws back. I hope you will find a good use to put them to; I may have mentioned above that there may still be a door in my old house secured with a beautiful stainless steel woodscrew which previously spent a year or two in a friend's tibia.

When I went for my six week check-up, my screw holes were still pretty visible on the X-ray; he didn't really give any reliable period for them to fill-in completely. He told me I was OK to run again if I wanted but to avoid jumping off buildings for six months.

I'm unsure how I write a post? This was the only way I could see how to do it!

I was 25 when I broke my hip, I slipped on wet grass! Any way, I was told that I was going to keep my 3 cannulated screws in forever. This is now not the case, they have been rubbing (quite painfully) against my thigh muscle causing me all sorts of problems for the last 2 years. I have had every possible physiotherpy, ranging from hydro pool sessions - accupuncture (all of these have been unsuccessful therefore I am still struggling)

I saw my surgeon every few months in the beginning (he was very aware of my pain) but after about a year and 3 months he decided that he didn't want to see me again until 2 years from the day I broke it had past, as he felt my hip wasn't strong enough to have these screws taken out. I decided to be referred to another surgeon at a different hospital.

I saw him on Friday, I will be operated on in about 8 weeks to have the screws removed. I am very nervous and would really appreciate advice or tips on all things to do with such removal please.

I am very appreciative of this forum where I can find out and read other peoples experiences.

I hope you all get better soon!

Dear sophiehip,
Please don't be nervous - there is absolutely no need for you to worry. I am almost six weeks on from the removal of the screws and it honestly is the best thing to have happened to me since the initial accident!
As in your case, my screws caused a good deal of discomfort and I was always aware of them -since they really limited my walking distance.
I won't pretend that you'll be entirely without a little pain and discomfort after the removal; but you'll be eating and drinking and walking to the loo very shortly after returning from the recovery room - although you must rest for a good 48 hours after your operation.
It might be a good idea to check with the surgeon exactly what type of stitches you are having - because I expected metal staples ( as with initial procedure) and really relaxed once I knew that I was getting dissolvable ones the second time around.
You will probably have a huge pressure dressing supporting the wound - which stays on for at least a day, but thereafter - a simple dressing. If you can, ask for a shower-proof dressing - so you can stay nice and fresh - it will make all the difference to your sense of recovery and well-being.
I came away with only one spare dressing - but had bought my own supply in advance - and would strongly suggest buying your own as 'back-up'. The waterproof post-op dressings types available are Op-site and Tegaderm and they can be purchased on Amazon and eBay.
At first you will be pretty bruised (because of all the manouvering the surgeon has to do to access the screw site) but your incision will be made over your original wound. Don't panic - it won't be bigger than before - in fact they try to make it smaller- and mine stopped short an inch of the original incision.
Three weeks after the operation, I was back swimming daily and can now sleep lying on my left side - which I haven't done in the 14 months since the accident. Apart from the holes making your fracture site temporarily more vulnerable - you can look forward to feeling 'normal' again!
I am going to have another physiotherapy session - but I think I am pretty self-sufficient when it comes to exercising. I tried to tell them all along that I'd be fine once the metalwork was gone - and I was right! Anyhow -everything falls into place once those damned screws have come out.
Oh, this is a 'girl' thing - but if you want to minimise your scarring once the wound is 'dressing-free' - I'd recommend Morhulin zinc and cod liver oil cream (which I always used for severe nappy rash) - but is a terrific skin healer on any scabbing.
Once you are 'scab-free' try Healgel ( available online) which was developed by plastic surgeons to deal with scarring - it is really great. Bio-oil is a cheaper alternative - but whatever you use, gently massaging the wound site is a really good idea.
Get yourself some good books/music/dvds ( or whatever floats your boat) and make sure someone gives you a nice big box of chocs and just generally prepare to be a little self-indulgent; after all, you've had a rough time!
I cannot understand why you have been left in pain for this long - but you can now look forward to feeling much, much better.
Wishing you all the very best - do let us know how it all goes!
X Teddylegs.

[Here2eternity]

Broke hip March 2011 when knocked off my bike by a car. Screws fitted. Received really good advice and support on a different forum site (thanks snibgo and goatwarden). The joint collapsed leaving screws sticking into soft tissue causing severe pain and reduced mobility - even today I am in as much discomfort as ever. The good, no great news is that on Monday I saw the consultant who told me the fracture has now healed and he can remove the pins in 2 or 3 weeks. Hopefully this will leave me much better. I have lost 2.5 cm on the affected leg but got built up shoes. I am 61 and had retired just before the accident with plans to tour.
Despite searching the Internet I never found a more useful resource than the CTC forum so thanks to everyone who contributes. All the other sites were about people who were back up in 3 months - life is not always like that.

[Teddylegs]

I think that you will be really pleased when you recover from the removal operation. Good luck and here's wishing you a speedy recovery.

[Here2eternity]

I think that you will be really pleased when you recover from the removal operation. Good luck and here's wishing you a speedy recovery.

Thanks Teddylegs - op is now scheduled for 26 June - delay mainly due to consultant's holiday commitments. I am sure it will be worth the wait

[markowe]

Just want to say that 9 months after my injury/operation, I have ridden an MTB marathon event (this one, but the medium distance, 54 km) with no ill effects, and even put in a reasonable time that was only a little off my old pace (about 13.5km/h average)!

The biggest worry (apart from a lack of training) was a potential fall - there are quite a few hairy downhills and it's hard to resist putting pedal to the metal..! Also, I was worried about overtaxing the injured leg (I still have screws in) so I found myself relying on the other leg more, with the result I have a bit of strain along that side.

But all in all I am REALLY happy - yes, you can get back in the saddle with an injury like this. My ambition when the screws come out is to get back into racing at the amateur Masters level I was at before, but that's going to be another couple of years...

So don't give up guys!

P.S. There is a limitation of coming back after an injury like this, that being that I really can't risk riding SPDs, i.e. clipped in, at least not until I have the screws out. Yes, it is really a retrograde step, but there is not much I can do... I wrote a little article on my blog about the disadvantages I noticed of going back to platform pedals.
P.P.S. Final results of the race I did last weekend, post-injury - I was 24th in a field of 76! I can hardly complain at that! I think I need to buy my surgeon a beer!

[Arturo]

My recent injury has a lot in common with the thread.
Dazzled by low sun, I managed to fall off in March by riding into a diagonal kerb (set into the road to segregate parking). I was unlucky to clip the kerb at just the wrong angle/speed to drop me into a single point impact on a raised pavement, without time to get a defensive arm out. The head of my left femur banged in to the acetabulum socket sufficiently to crack and break up the pelvis bone and hip. BIG ouch! When the radiologist says “you made a good job of that”, it is not a complement!
After a week at Huddersfield Royal Infirmary, I was transferred to Sheffield Northern General for an operation to pin the joint. Escaped from hospital two weeks later to recuperate at home. Progressive physiotherapy through three months on crutches (no load), followed by rebuilding muscle and learning to walk again has led to a gradual build up and extension of performance. The joint will be impaired (versus pre-accident), but impossible to predict how much. Recuperation looks like a long road, but I’m over the moon to be vertical again, and can see light at the end of the tunnel.
The injury has been a roller coaster of experience and emotion. The quality of care and compassion has been magnificent – I’ve had the privilege to meet some very talented and committed people. Despite systematic under-manning, there is a hard core of caring NHS professionals who aren’t prepared to let horrible working conditions and low pay get in the way of looking after patients. I’m forever grateful; the value of a smile and cheerful disposition for morale cannot be over-stated.
I remain committed to cycling and I’m itching to get back on the road. My surgeon is keen to encourage me, but did warn that a similar fall could have big complications due to the embedded plates and pins. I have started to look at body armour. There are padded/armoured shorts advertised for off road, but I’ve no idea how practical they would be for road use? Has anyone any experience or advice to offer?
Thanks,
Arthur

[snibgo]

You have my sympathies. Get well soon!

I have seen "hip protectors" for sale on the web. They seem to be padding worn beneath clothing, to cushion falls, I suppose. I've never tried them -- just been very careful not to fall off again.

[markowe]

I tried to track down something along the lines of hip protection but couldn't really find anything - probably just Googling the wrong thing. If anyone has any links to such products on eBay or wherever, looks like more than a few of us would be interested!

[snibgo]

A few that came up on a casual search:

http://www.ebay.com/itm/MX-DH-BMX-Padde ... 0701587639
https://www.win-health.com/actinic/acat ... horts.html
http://www.betterlifehealthcare.com/pro ... &subID=579

[markowe]

A few that came up on a casual search:

http://www.ebay.com/itm/MX-DH-BMX-Padde ... 0701587639
https://www.win-health.com/actinic/acat ... horts.html
http://www.betterlifehealthcare.com/pro ... &subID=579

Awesome, thanks, I wonder what I was searching for. That downhill body armour looks awesome, maybe that is the way to go, just as long as I don't get tempted to get into DH . If I'd been wearing something like that last year I guess thing's would've probably turned out differently...