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Fractured Neck of Femur/Pinning Recovery questions.

Eivar

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Hello all,

So glad I have found this forum and to know that I am not so alone with my recovery! On 15 January of this year, I fell approximately six feet from a roof onto a wooden deck and broke my left femoral neck/arch. I went to the hospital immediately and was admitted and had emergency hip pinning surgery the following morning; three long screws. I spent several days in the hospital recovering from the surgery and when I was discharged, I was told I would be on crutches for 8–12 weeks. I was started on PT a week after my discharge.

During a follow-up appointment with my orthopedic surgeon (the same one who operated on me), just shy of six weeks since my surgery, he told me to stop using the crutches and that I could begin bearing full weight on my leg, and I have continued with PT three times a week. I have purchased a cane, but have to admit around the house, I often don't use it. I have also walked my dogs several blocks, but with my cane, although I know maybe I shouldn't.

I am still having a lot of discomfort and some pain. The pain is in my outer hip area, sort of where my surgery scar is, but much deeper down; feels like the bone. Also, I am having pain deep within my buttock, also seemingly at the joint/bone, and some sharp pain that occasionally seems to catch in my groin. Oddly, I also seem to have pain now in my left knee, but on the inner side, not outer side. I am not sure if this is normal or if I am overexerting myself?

I am absolutely terrified of the thought of having AVN. My doctor brought up the possibility of AVN before I even went into surgery on the day of my accident and now makes mention of the possibility every time I see him, but has thus far says he thinks everything is "fine", although he only sees me for about two minutes each visit and merely looks at my most recent x-rays.

I realize every case/fracture/surgery/recovery is unique, but I am wondering if this sounds like I am progressing normally? Should I be overly concerned about the pain and AVN or am I being paranoid? I am curious to maybe hear some thoughts from other people who have gone through this type of surgery for this injury and hear some of your experiences.
 

Layla

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Hello @Eivar :welome:

Welcome to BoneSmart. Thanks for joining us here. I’m so very sorry to hear about your accident and also that you’re frightened by the possibility of AVN. As difficult as it is, I’d try not to borrow trouble, making a great effort to take things one day at a time. If further surgery becomes necessary, you’ll deal with it just as you’re dealing with this. We’ll be here for you always.

Following are the Recovery Guidelines for THR, but much of the info applies. Possibly you should consider stepping away from the PT for a time and using rest, ice and OTC meds as needed. We do recommend icing all areas of discomfort several times per day for no less than 45-60 minutes each time you ice. I’m wondering if your opposite knee is bothering you due to favoring your op leg as it’s healing, or as your body adjusts to a changing gait once again.

Please continue to join us here for support and encouragement.
Wishing you comfort and perfect healing. :)

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: 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.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Debru4

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That fall you took most likely caused bruising in multiple areas, and that may be some of the pain you are feeling. If your doctor is monitoring you and the hip looks good, that is positive. Has he ordered any labs or other tests to see if anything else might be going on, or if you might have also injured your knee or back in the fall?

If it were me I would take a couple of weeks off of PT and would reset, and do the things you typically do right after a major surgery on a joint.....things like icing, resting, elevating, simple movement and activity, and using acetaminophen or some pain relief. It seems that most people I have read about here on the forum have positive results when they do that if they continue to experience pain. I hope things settle down for you--just remember, there is rarely a benefit to rushing things, and often a problem if you do....go slow to go fast.:) :-) (:
 

Hobbling Along

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@Eivar When you walk to you walk upright or lean to your unaffected side. I know I was guilty of this and as much as it pained me even although my consultant told me to full weight bare get rid of crutches this was near impossible without giving other pains.

I continued longer on my crutch sometimes just one but at 12 weeks I feel it’s was worth not being so hard on myself it saves that twisting of back and compensating elsewhere.

I hope things improve for you and I would certainly say it’s only in the last couple of weeks I’ve relaxed about AVN and the bone pain has gone. I think it just takes a bit longer to heal for the force we out through than the X Ray May indicate its grafting but not fully healed

good luck in your recovery
 
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Eivar

Eivar

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Thank you all so much for your replies! I am really grateful! I have taken your advice and decided to stop PT for now and slow down a bit and not try to rush my recovery and it has actually been very helpful. Since posting last week, I have been doing very minimal exercises – just walking a bit – and the pain I had been experiencing has diminished to almost nothing. My orthopaedic surgeon prescribed me some anti-inflammatory medication as well, and that seems to have helped.

@Eivar When you walk to you walk upright or lean to your unaffected side. I know I was guilty of this and as much as it pained me even although my consultant told me to full weight bare get rid of crutches this was near impossible without giving other pains.
I think this was part of my problem as well. After I began full weight-bearing, my gait made it so the muscles were sort of twisting in some odd ways and causing me a great deal of pain.

That fall you took most likely caused bruising in multiple areas, and that may be some of the pain you are feeling. If your doctor is monitoring you and the hip looks good, that is positive. Has he ordered any labs or other tests to see if anything else might be going on, or if you might have also injured your knee or back in the fall?
The only thing my doctor has done is to look at x-rays. I haven't had any other tests done. I have read that an MRI is probably the best way to determine with some certainty what is going on, but he has not ordered one. I saw him this week and it was the same – he just ordered an x-ray the day before I saw him. He said it looks "fine". But, I would probably be more relieved if I had an MRI.

As of now, I am just pleased an slightly more relaxed that the pain has greatly subsided. No doubt stopping PT and just walking has helped tremendously. Not sure why they would make someone who had just broken a femoral neck and had surgery with pinning start PT a week afterward. Now that I think about it, it seems a bit...counterproductive.

Thanks again for the replies. I will update on the progress (or setbacks).
 

Eman85

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No doubt stopping PT and just walking has helped tremendously. Not sure why they would make someone who had just broken a femoral neck and had surgery with pinning start PT a week afterward. Now that I think about it, it seems a bit...counterproductive.
I think we've all asked a similar question. With a THR it's always a big deal about getting up and walking right after the operation, which is good because it gives you the ability to walk to the bathroom. Then the next day they get you in PT which many times includes actual exercises. I've been in that and they actually try and force people to do leg lifts that many can't do and are crying in pain. Crazy!
 

Jaycey

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Not sure why they would make someone who had just broken a femoral neck and had surgery with pinning start PT a week afterward. Now that I think about it, it seems a bit...counterproductive.
Totally counterproductive. You are recovering from an injury - not training for a marathon. Glad you are starting to see progress!
 

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