Fractured Neck of Femur/Pinning Hip Pinning Recovery Advice

[evangelinaleon]

Hi all, I'm looking to see if anyone has experienced something similar or if anyone has any advice to offer me. I'd really appreciate it!

Last year when I was walking to work, I tripped and fell in the street and I badly fractured my femoral head and acetabulum. I had hip pinning surgery and am currently 7 months post-op. This was a very traumatic experience for me because it was so sudden and unexpected, especially as a 25-year-old woman that goes to the gym every day and takes really good care of herself.

I've been able to improve my strength and per my surgeon, my joint and bone look good with no sign of complications. However, I still walk with a cane and experience tightness throughout my leg, especially my knee and hip. My hip flexors and quads feel very tight and I notice snapping, tension, and pain in my knee and hip when I get up or if I straighten my leg. Because of this tightness, I often have trouble walking without a limp. PT has not been helpful and I've done everything from stretching to strength exercises, but they've only provided very marginal improvements. My surgeon does not know what's wrong and hasn't suggested anything.

 

[Snoopy55]

Hi I am so sorry you are still hurting after 7 months. I had hip pinning surgery as well after a skiing accident in February so I am just about 3 months post op. I fractured my fremoral neck as well but it was non displaced and I have three pins in. I am still on a cane as well although If you read my thread I did lots of stuff I should not have (I traveled abroad and so on) so I am recovering a little slower than I would like. One reason being that my surgeon kept telling me that the fracture had 100 percent healed and so I started agressively doing PT and walking.

When I got back from my trip I decided to get a second opinion and that doctor said that the fracture was HEALING and not HEALED, so a very different thing than what my surgeon told me. He said it would take 4 to 6 months to completely heal. So the last couple of weeks I have been resting more, icing more and I went to the swimming pool to swim (not in the lap lanes just the baby pool) and walk in the water and do some bicycles. But really I just kind of mentally came to terms with the fact that I had a traumatic injury which would take longer than I liked to heal.

It really seems like a second opinion might be in store for you since you are 7 months post op and still experiencing pain and discomfort but maybe you are also over doing it because your surgeon has told you everything is healed when in fact its still in the process of healing? Just a thought as I am not doctor but just sharing my own experience. I hope that it helps. But you have definitely found a great site as everyone here is very supportive and has lots of knowledge and experience. Welcome! I guess I should have said that at the beginning lol.

 

[Layla]

Hello and Welcome to BoneSmart, we’re glad you’re here!
I’m sorry for the accident that necessitated the hip pinning. Please share the date of your hip pinning and which hip it is and we’ll create a signature for you.

We remind members that recovery from THR can take a full year. My understanding is that hip pinning can take just as long and sometimes even longer.

I do agree with, Snoopy55, that it may be that your activity is the problem, specifically the possibility of something you’re doing, or have done, while in therapy.

Tightness is often swelling. Is your leg swollen? If so, consider icing and elevation if you’re not already and also continue to use an assistive device, as you’re doing for as long as you’re limping. Practice heel - toe walking.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe.
It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.
Here is a visual on heel-toe walking -

If you’re still in PT, consider stepping away for several weeks. During that time, I’d suggest icing and elevation if swelling is still involved and get your exercise through the activities of daily living, along with some walking, but not to excess. Try it and see if you notice any improvement.
Here are articles on Icing and Elevation.
https://bonesmart.org/forum/threads/ice-to-control-pain-and-swelling.5493/
https://bonesmart.org/forum/threads/pain-and-swelling-control-elevation-is-the-key.7602/

I wish you relief and all the best! Stay in touch.

 

[evangelinaleon]

I did take a break from PT for a couple of weeks and I decided to book with another PT next week because the one I was seeing was saying a lot of questionable things and would never make me feel better. The only helpful thing the PT did was to help me walk heel-toe and correct bad walking habits. I had my procedure on October 28th, 2021 on my right hip.

I have been aggressively doing PT because I'm at a huge risk of developing arthritis (dislocated, displaced, irrecoverable bone and joint fragments). I will be seeing another orthopedic surgeon for a second opinion, but I am afraid they will encourage me to do a THR. I really don't want to have to go through hip surgery and recovery again, especially 4 more times due to my age.

Snoopy, I did read your thread and I'm also very sorry to hear about your accident. I can't believe you went on a big trip while recovering. My hip already starts acting up after sitting for only an hour, I can't imagine a 7-hour plane ride! Do you also have problems getting up from the chair and experiencing intense hip snapping? I also have problems doing hip flexion which makes going up the stairs an ordeal. I don't have any swelling, just tightness/tension and snapping at my hip and knee.

 

[Layla]

I’m sorry your last PT was a disappointment. I wish you the best with your appointment with the new surgeon. I hope you like him / her and feel confident in their advice.
Thanks for the surgery date, we’ll create your signature to reflect the info.
I hope you have a nice week!
@evangelinaleon

 

[Snoopy55]

hi @evangelinaleon I am glad you stopped PT and are getting a second opinion-both good steps! I had a great time on the trip but like I said I listened to my OS who said everything was healed and he OK'd the trip but I really should not have done it. I iced the whole way as you read and I was back on Tramadol until just a week or so ago where I transitioned to extra strength tylenol. I still take Mobic once right before bed which I believe is helping with the inflammation. I was also doing PT before my trip but I over did it and set myself back at least a month.

I have learned as someone said on this lovely forum "faster is slower and slower is faster". I realize you are very young at 24 and want to get back to life ( I have a 24 year old daughter) and believe me I do as well even though I am alot older than you-having your hip break at any age is no joke and you have to let it heal. Not just the bones but the tissues and the muscles. The more you aggravate it the longer it will take so take it one day at a time and don't over do it at PT.

I don't have any of the snapping sounds you are describing in either my hip or my knee. I go up and down the stairs like a toddler-one leg at a time because my leg isn't strong enough to put that much pressure on it just yet but I think once I start PT again my leg will start to get stronger slowly. I just really don't want to aggravate anything right now I am feeling so much better. Please keep us in the loop as to how you are doing with the PT and the second opinion. You will find lots of support here as I did.

 

[I’vegotthis!]

Hi- I know exactly how you feel. I also suffered a fractured neck of femur at 44 suddenly in a slip and as a gym goer and very active person it knocked me for 6. I was exactly like yourself and was very conscious of AVN that I got back to the gym and in hindsight probably over did it! I had a ct scan at 10 months as I was still in pain suffering with knee problems, tightness and snapping/ popping. You can imagine my surprise when they said the fracture had collapsed due to lack of blood supply especially since I had a scan at 6 months and everything showed healing looked good. I don’t want to panic you but I went on to have a THR in February of this year. I know it seems disappointing especially after it seemed like the DHS had done its job but if it’s what your leg needs to recover then so be it. The surgery is easier than the pinning- not sure if it’s because it’s planned so not so much of a shock! I am 10 week post op and although still on crutches I am already much better than at 10 month post op on the pinning. Hoping for a full recovery. Keep going and if you want to talk or ask any questions you know where I am.

 

[evangelinaleon]

I certainly hope I don't have AVN and don't develop it, but I know it's definitely possible given the dislocation and the severity of the injury.

I tried my best to explain my problem to the surgeon, and my dad and SO worked really hard to advocate for me at the office. The doc thinks it has "something to do with the IT band" and PT will fix the problem.

Hopefully, that is what is. I definitely pushed myself too hard with leg/hip exercises as I am very eager to get back to squats and hiking. I will finish my 3-week hiatus from PT and resume next week with a different PT. I will let you all know how it goes, thanks for the support and great words of advice.

Sincerely,
Evangelina

 

[Age28March2022]

Just to share my experience which is quite similar to yours.

I had skiing accident in March last year and broke my femoral neck and had pinning as well, but the pain was still there even 1 year later even though the femoral neck has healed (but my leg has become 1cm+ shorter).
X-ray and MRI this March showed that my femoral head is deteriorating (AVN probably around stage 3) and was told to have partial hip replacement surgery.

I am not saying your femoral head is damaged or what or it could still be at early stage and x-ray can't detect well. I think MRI can see it better at early stage

 

[Snoopy55]

@Age28March2022 wow thats vert upsetting to hear that after a year you still have pain. Was your fracture displaced or non-displaced?

 

[Age28March2022]

@Age28March2022 wow thats vert upsetting to hear that after a year you still have pain. Was your fracture displaced or non-displaced?

Displaced. See the bottom pic

 

[Snoopy55]

@Age28March2022 ooh that looks very painful. I am so sorry:( hope youre doing ok. Maybe you should start your own thread and get some advice/feedback from others like I did. Just a suggestion.

 

[evangelinaleon]

Thanks for sharing @Age28March2022. I'm sorry to hear that you also experienced complications after your hip pinning surgery. I'm surprised you experienced that because your XRay looks much better compared to mine.

I eventually got a second opinion and the truth is my surgeon was dead wrong about my recovery. I will be doing a hip preservation surgery (Periacetabular Osteotomy) in a couple of weeks. I was recommended against a hip replacement because I am too young to get one and my bone is still viable (no AVN). Also I was told I couldn't play sports or live an active lifestyle in order to preserve the replacement for as long as possible.

Moral of my story: always get a second (or third or even fourth) opinion if you are not recovering as expected and your surgeon is not doing anything to help you!

 

[Snoopy55]

Glad you decided to get a second opinion. Hopefully this surgery will allow you to get back to the things you love like playing sports and being active. Let us know how you get on and good luck!

 

[Age28March2022]

@evangelinaleon

> I'm surprised you experienced that because your XRay looks much better compared to mine.

Do you mean the x-ray of my pinning look better than yours or the severity of my injury? I assume you mean the former.

The pinning x-ray picture I posted was right after my surgery. It looked good at first but few months down the line the femoral neck is getting shorter (as shown in the picture below at 1 year post OP). I could feel that my leg was getting shorter.

 

[evangelinaleon]

@Age28March2022

Do you mean the x-ray of my pinning look better than yours or the severity of my injury? I assume you mean the former.

The pinning x-ray picture I posted was right after my surgery. It looked good at first but few months down the line the femoral neck is getting shorter (as shown in the picture below at 1 year post OP). I could feel that my leg was getting shorter.

I would say your injury was not as severe as mine (your injury is still severe of course). My hip doesn't even look like a hip anymore... How are you doing now? Did you do a hip replacement?

My PAO surgery was canceled because they eventually found signs of AVN in my femoral head and signs of osteoarthritis. I have to do a total hip replacement now and I am not even eligible for hip resurfacing, so disappointing.

 

[Layla]

I have to do a total hip replacement now and I am not even eligible for hip resurfacing, so disappointing.

I am sorry for all you've been through with your hip. While I understand your disappointment I believe this will be the option that gives you your life back, the way it was before the accident and resulting injury when you were living and functioning without struggles or pain. If you'd be willing to share your surgery date when you get it scheduled, we'll gladly support you on the journey. Hang in there, I do believe brighter days are on the way.

 

[evangelinaleon]

Thank you Layla. My surgery is coming up very soon! It'll be on the 29th of August!

 

[Layla]

That is soon. Only three days to go. I hope you have your recovery nest all ready for your healing journey. Soon you'll be back home with surgery behind you and slowly returning to a life without hip pain.
I wish you only the best and hope you'll join us on the Hip Recovery Forum once you're post op. We'll have lots of great info to share there as well as the support of members. Please join us!
@evangelinaleon

 

[evangelinaleon]

That is soon. Only three days to go. I hope you have your recovery nest all ready for your healing journey. Soon you'll be back home with surgery behind you and slowly returning to a life without hip pain.
I wish you only the best and hope you'll join us on the Hip Recovery Forum once you're post op. We'll have lots of great info to share there as well as the support of members. Please join us!
@evangelinaleon

Thanks @Layla I'm excited and anxious! Just wanted to ask you, after your posterior THR, why did your doctor not prescribe hip precautions? And did you use a cane or walker after surgery?