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[Fractured neck of Femur/pinning] 3 weeks after pinning and I'm scared

Discussion in 'Hip Replacement Recovery Area' started by MMCDOWELL, Aug 31, 2017.

  1. MMCDOWELL

    MMCDOWELL new member
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    I had an emergency hip pinning three weeks ago after a ski gondola accident. They couldn't get me to a hospital large enough to do the surgery for 36 hours or so. We left it to the doctor to decide rather to pin or replace and he said it looked like my bone was healthy enough to pin and keep my own hip.

    I haven't had much pain (no pain meds necessary after the first few days) but today, three weeks post op, I'm feeling pain from my glutes down to the back of my knee and my leg looks a little swollen. I did reach forward for something on the ground from my wheel chair and I'm wondering if that is the issue.

    The doctor in BC said no weight bearing for three months but when I visited the surgeon here in the US he said to go ahead with 50% weight bearing so I am toe touching when using my walker.

    After looking at all the possible issues with hip pinning I'm a bit stressed. Blood clots, bone death...geeze! It's enough to scare anyone. I think I just need some assuring words.

    I have another appointment on the 23rd. Had one at two weeks post op and they said no healing had occurred but no loss of bone either. Anyone know when they should see healing?

    How much exercise is too much? Is there such a thing as too little? I heard I shouldn't be bending all the way forward but it wasn't uncomfortable until now. Is it something I should avoid? So many questions. Sorry. Since this is the first pain I've had it's thrown me for a loop!
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @MMCDOWELL Welcome to BoneSmart! So sorry you are joining us due to pain!

    I am a bit surprised you didn't need pain meds just post op. But I guess if you were not putting weight on the hip that would ease things. Now that you are 50% weight bearing that certainly would cause the hip to complain. After all you had an accident and then there was the trauma of the pinning op.

    There are risks involved with any procedure. I would suggest reading around this forum versus the horror stories you can find all over the internet. Are you taking any drugs to thin your blood? You might as the surgeon about this if you are worried about clots.
    I'm not a medical expert but I will tag our expert @Josephine to comment on this.
    No need for extensive exercise. Walking is the best exercise for a healing hip - and then not to excess.
    Did your surgeon give you any restrictions? Many surgeons are not imposing restrictions these days. The standard seems to be if it hurts don't do it.

    Have a read in our Library. Lots of information for you there!
     
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  3. alexthecat

    alexthecat MODERATOR Administrator

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    Welcome to Bonesmart! Like you, I also had a hip pinning. Mine failed, but I hope you will have better luck than I did. It sounds like you are doing well so far.

    The advice about not flexing the hip sometimes applies to people who have had hip replacement. Your hip was pinned, so that has nothing to do with you. Don't even worry about it. Just smile and nod. That's what I always did. Your pain level will tell you what you can do.

    Here is a short reading list about recovering from hip pinning. I hope that is useful to you.

    Pain management and the pain chart
    The Myth of Addiction
    Pain and swelling control: elevation can help
    Using Ice

    Recovery Aids
    How to Use Crutches
    Warning about Armpit Crutches
    Recliners

    Blood Thinners
    Constipation and Stool Softeners

    Energy Drain
    Sleep Deprivation
    Post Op Blues
    Accepting Help
     
  4. MMCDOWELL

    MMCDOWELL new member
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    Thank you so much everyone! There is comfort in just knowing others are out there. So much to take in.

    Jaycey, I too have been surprised at the lack of pain. I took it easy today and the pain from yesterday is gone and I'm back to normal. It feels best when I stand in my walker with legs straight and feet forward, not putting weight on the bad hip of course. Pretend standing.

    I am on 325mg of aspirin twice daily for a blood thinner and my original surgeon said non weight bearing for three months but the surgeons here in the States said non weight bearing with toe touch for six weeks and we would look at the situation then. No one has allowed walking.

    Alex, thanks for the reading list. I'm so sorry to hear yours failed. It looks like you had it in July and a full in March. What was the revision in between?

    I was so shocked at the high rate of failure! I cringe at the thought of having another surgery. I laid on the ground in the sun for two hours before they took me in and I was pretty dehydrated. They tried to find veins everywhere so I was bruised from hand to elbow on both arms. Right now the thought of ever seeing another needle makes my knees weak!
     
  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    My friend just focus on healing now. Everyone heals differently and you should not compare your results to any other recovery. Early days!
     
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  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    @MMCDOWELL hi and welcome to BoneSmart!
    Please try not to worry about future needles. The reason they had such a problem after the accident was because of the dehydration! It makes the veins simply disappear because your blood has lost volume and your body's natural reaction is to take all the remaining blood into the core of your body to keep essential organs such as the heart, liver, lungs and brain, functioning. That's what dehydration is!
    I've spent most of my career (almost from day one!) dealing with fractured hips and so I know quite a bit about them. I would surmise that you had a fractured neck or subcapital fracture (under the head). This means that the blood supply to the head is compromised like this

    The blue dotted line is the fracture and the blue stars show where the blood supply is disrupted.
    The green arrows represents the blood flow from the bone marrow which is probably the most important source.

    blood supply in NOF.gif


    If the fracture is undisplaced then the head has a fair chance of surviving but generally the longer before the fracture is fixed, the less likely it is to survive. You then have a a condition know as AVN or avascular necrosis (bone death due to lack of blood supply). I think that very likely this is what your current problem is.
    It's not specifically connected with hip pinning, it's with ALL surgeries, even minor ones like ingrowing toe nail!
    Well no, but there is a such a thing as too much!

    Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

    I don't know who told you that (who did tell you that?) but it only applies to hip replacement patients whose hip has been dislocated during surgery. And even then, only a very few hip surgeons impose such restrictions.
    Please don't apologise - that's exactly what BoneSmart exists for!
     
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  7. alexthecat

    alexthecat MODERATOR Administrator

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    There was a problem with the initial hardware in that hip. In the revision, that hardware was removed and they put in different hardware. It was something that was very specific to my situation, so don't worry about that. It's not something that will happen to you.



    Sent from my Z799VL using Tapatalk
     
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  8. lalo

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    I'm sorry about your accident. I was in a bike accident two and half years ago and broke my hip.
    My orthopedic Dr had recently retired and the on call Dr decided to try pinning rather than a replacement.
    My pinning was not successful. I was on non weight bearing for 6 weeks. After that I started physical therapy.
    In my opinion the therapy was the reason the pinning failed. They had me doing exercises that I couldn't even do before I broke my hip. However, the desire to recover is so strong that I was willing to do anything if it helped to get well. In hindsight I should have walked out if that therapy clinic.
    So my two cents be careful with therapy and trust your intuition; if you think you should not be doing a particular exercise don't do it.
    Wish you the best.
     
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  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I feel I should put in some explanatory points about fractured neck of femur. The decision to pin or not is not an arbitrary decision by the surgeon but based on clear parameters of what we know will work and what is unlikely to work. It's all based upon the type of fracture, the impact on the blood supply to the head and what stage the vascularity is at that time.

    The circulation is complex
    blood supply in NOF.gif

    Here you can see the three lanes of blood supply, two of which, marked by blue stars, are inevitably disrupted by the fracture. The third and central lane is via the bone marrow itself and is also inevitably disrupted. If the thrid lane can be reconnected by a good and early fixation with pins, then the femoral head stands a jolly good chance of surviving.

    However, if the fracture is displaced and/or the time lapsed before surgery is done, the head is likely to have suffered early death - avascular necrosis - as a result. There is often no way for the surgeon to predict this with any certainty and it doesn't show up on xrays (no MRI at that time!) until one or even more days later.

    Just thought you'd all like to know!
     
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  10. MMCDOWELL

    MMCDOWELL new member
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    i am hoping this is not my current problem . I do fear it though. I'll know more on the 23rd when I go back for more X-rays. it is exactly what happened. The neck was severed. Would give anything for a story from someone that begins with "I had my hip pinned and it was a huge success".
     
  11. MMCDOWELL

    MMCDOWELL new member
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    Thanks Lalo. I feel like everyone is in a rush to have me running. I get a constant "you can do that" and "you need to move more" from many people. The doctor in Canada that pinned it said 3 months with no weight baring but everyone here seems to be pushing movement. I think it's hard for my husband because he's used to me being very independent. It's hard for me because I feel so dependent. How long was it before they determined yours had failed and what were the symptoms of that?
     
  12. MMCDOWELL

    MMCDOWELL new member
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    It was in the literature I brought home with me. It was pretty general to hip surgery so it was hard to weed through what applied and what did not.
     
  13. lalo

    lalo member

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    My pinning was performed on Feb 11. 2015. I was non weight bearing for 6 weeks, which takes me to end of March. During that time I had several x rays taken. The results showed that the bones were healing. The Dr referred to it as "knitting"; it showed "white" on the X rays. I started physical therapy around 1st week in April. The 1st several sessions were pretty benign. There was a session where I had to place full weight on the operated leg and balance myself for 15 to ?? Seconds at a time, for multiple reps.
    When I came home, the knee, which had been replaced some years before, swelled up. I complained to the staff but I think the damage was done. Subsequent sessions backed off the hard exercises.
    On the next Dr visit the x ray showed the screw heads portruding beyond the bone. This was around mid April. I was taking meds so my pain was manageable. However, I remember feeling nasuated and wanting to throw up. This sensation was new. On the next and final Dr visit which was around early May the Dr said I had gone to " non union" and I would have to have my hip replaced. The X-rays that were taken on last visit showed screws about half inch above the bone.
    Sorry if my answer went on too long but I wanted to be as accurate as possible.
     
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  14. alexthecat

    alexthecat MODERATOR Administrator

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  15. alexthecat

    alexthecat MODERATOR Administrator

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    I know two people in my offline life who can say that. You aren't likely to find people like that here though. They just recovered and got on with their lives.
     
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  16. lalo

    lalo member

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    My wife has a sister that had a successful hip pinning and I have 2 friends from work who have family members who also had successful pinning ops.
     
  17. Layla

    Layla FORUM ADVISOR Forum Advisor

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    I'm unfamiliar with this procedure. I'm sorry you are experiencing this.
    Prayers for comfort, peace of mind and resolution. Take care.
    @MMCDOWELL
     
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  18. MMCDOWELL

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    Thank you Layla.
     
  19. MMCDOWELL

    MMCDOWELL new member
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    Oh lalo! I know it's silly but you have no idea how much hearing that helps!
     
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  20. MMCDOWELL

    MMCDOWELL new member
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    I wanted to update and perhaps give some others some hope.

    A few weeks ago I was scared to death. I couldn't imagine a time where I could see a light at the end of the tunnel. I felt broken and I didn't think many people understood what I was going through because the incisions were small and, from the outside, it didn't look like much of an operation.

    People pushed because that's what they thought was right. "Surely you can make it up those stairs with your walker. I'm sure you can sit in your wheel chair through the hockey game."

    My legs and knee swelled terribly in the first six weeks and I found it was easiest to sleep on a recliner with my leg elevated. At first a lot of people came to visit but after a few weeks that ended and I had a lot of time to worry. Was I walking too much? Was I walking too little? Was that pain because I hurt something? I never had a lot of constant pain but I had awful twinges, especially if I was turning right with my walker or tried to push myself up to a sitting position.

    I also had a few big scares. Once I was sitting and crossed at the ankles and I went to uncross and my leg wouldn't move. It hurt so bad that I thought we were going to have to call an ambulance. One night I woke up to such a horrible charlie horse in my leg that I thought for sure I had a blood clot. I was so afraid.

    I'm no way out of the woods. My doctor says I won't really know if this is a total success for 11 months to a year. However, last week I was 1/3 weight bearing, this week I'm 2/3rds and next week I'm supposed to TRY full weight. BTW, I read back and saw that I said I was 50% weight baring after 6 weeks. After I posted that I had a discussion with my doctor and he said toe touch only.

    My doctor said to stop if there is pain. He is not sending me for PT because he says they will push and this kind of injury, true to what I read on this site, will do best with a slow and easy healing. I still sleep on the recliner because my bed is really high but the swelling seems to be under control.

    I guess what I'm trying to say is that if you are at the beginning of this journey there will be a lot of fear and uncertainty. Listen to your body. When you worry look at where you were a week ago and notice the progress.

    Next week I see the doctor again. Another xray. So far he hasn't been certain, even at 7 weeks, that there has been healing. I am, however, finally feeling strong enough to take it a day at a time. I'll do my best, my doctor will do his best and what will be will be. Be glad and make use of the camaraderie on this site. This site is amazing and it helps a ton to know there are others out there. Thank you everyone for answering. XXOO
     
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    Last edited: Oct 3, 2017

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