Fractured Neck of Femur/Pinning Triathlete with Broken Hip Needs Advice!

[Reno Cyclist]

Hi everyone, thank you for reading this, and for any help, guidance, thoughts, tips, etc.

I’m six days postop fractured hip. I was mountain biking and crashed, slamming my hip into hardpack dirt. I am 53, an avid runner, biker and swimmer, who has never had surgery. Until now. The pain was traumatic, but is over now. I was Lucky to have a well known excellent surgeon, who told me all went well during the procedure. He “pinned” me with two screws at the femoral neck. Diagnosis on X-ray:

“There is a acute mildly angulated intertrochanteric left femoral neck fracture
No dislocation.
Mild degenerative changes of the hips.
Bone mineralization is age-appropriate..”

I‘ve got very little pain, just stiffness, and am taking Tylenol only along with blood thinners and routine vitamins. I was in extremely good shape when I crashed, training with the goal of a half Ironman and several shorter races this year, including potentially a marathon.
Problem is, I’m not sure exactly what to do now, or what to expect. Much of his instructions post op are a blur, and all I have is a one-pager describing some exercises to do each day. I kinda feel like I’m on my own, left to figure this out in what appears to be an extremely critical healing period. I have questions!

Like:
1. Researching hip fractures turned up scary stuff. 1 in 3 hip fracture patients die within in a year? OMG. Why? How do I reduce the risk of that happening?
2. What should I be doing now (or not doing now) to speed healing and recovery? Just follow the four minor exercises I was given (a sheet meant for THR patients)
3. Are there dietary supplements I should be taking?
4. How long until I can walk?
5. Looking in the mirror, it appears the hip that was operated on is literally two inches higher than the other hip. ?
6. Will I ever run again?
7. How long do I have to wear these compression socks?
8. Are there resources for dealing with what I know I will experience: lack of fitness, and the mental benefits that I always derive from long swims, bikes, or runs?
Well, thank you to anyone who listens and wishes to comment or provide advice. I really am all ears and hoping to learn from your experience and expertise in something new, foreign and pretty scary to me!

 

[Sockeyewillie]

Wow! Sorry to hear about your accident. Let’s think about your questions
1: I’d bet that statistic is affected by the average age of the fractured hip patients. Many elderly suffer fractures due to falling and their survivor rate is probably much lower than the active 53 year old group.
2: First you need to recover from surgery. This will take longer than you might expect. Ice, ice baby.
3: no comment
4: as soon as a PT says you can.
5: You just had surgery and an injury. Wait for the swelling to go down.

Hang in there, you’ll get better.

 

[myglasshalffull]

Welcome you will find a wealth of information and support here.
Sorry to hear about your accident.
I also had hip fracture after falling on ice in my yard.
I had hip replacement not pinning but no matter the recovery does take up to one year for some of us.
I would search "Snoopy's" reports, she had hip pinning after ski accident around same time I was hurt.
You are young and I'm pretty sure you will bounce back with time and patience.
Relax, ice, get up and walk here and there. Are you on a walker???
Only exercise you should be doing down are some ankle pumps and walking, hips don't need a lot of exercise to recover. For most of us walking was our exercise.
I would try and eat very healthy, it's important in your recovery cause your body is using all its energy to heal right now.

 

[Reno Cyclist]

Thank you! Yes, I am on a walker to take showers and use crutches to get around.

 

[myglasshalffull]

So get up every few hours and take a walk around the house, I used to walk around my dining table 5-10 times in one direction and then change directions.
Recovery can become boring and depressing so if the blues settle in just know you are not alone.
When I first had my surgery PT told me I'd be A OK in 30 days! No way!!!
Even though I was 70 at time of accident I am a very active person walking rescue dogs several miles per day and I worked in a very busy restaurant 2-3 shifts per week.
Thank goodness I had a partner that could help me, although from Day one once I returned home I could cook and make coffee and clean kitchen up.
Keep reading here and you will see we all had some similarities in our recoveries. As far as the socks by Day 4 mine were off.

 

[Jaycey]

@Reno Cyclist Welcome to BoneSmart! So sorry about your accident! The good news is that you will get back to active living again. The key is don't push through anything and give that hip time to heal before starting any training.

1. Researching hip fractures turned up scary stuff. 1 in 3 hip fracture patients die within in a year? OMG. Why? How do I reduce the risk of that happening?

Sockeye is right - in incidence of hip fractures in elderly patients is high. Unfortunately many suffer complications due to other health issues while trying to recover from major trauma. Please don't worry - you are young and healthy.

2. What should I be doing now (or not doing now) to speed healing and recovery?

There is literally nothing you can do to speed healing and recovery. Patience is the biggest challenge especially for those who have been very active. Once you are released to bear weight on that hip, walking is the best exercise.

3. Are there dietary supplements I should be taking?

No, supplements won't really impact any healing.

4. How long until I can walk?

Did the surgeon impose weight bearing restrictions? Be sure and clarify this with their office.

5. Looking in the mirror, it appears the hip that was operated on is literally two inches higher than the other hip. ?

Swelling and soft tissue trauma. Please don't worry about this. It will all ease with time.

6. Will I ever run again?

Another thing to discuss with your surgeon. Only they know what condition that joint is in and they will be able to monitor how it is healing.

7. How long do I have to wear these compression socks?

Another question for your surgeon. Some patients have to wear them for 6 weeks post op. Then there are others who don't require them at all. It's really surgeon dependent.

Your fitness level may decrease as you allow your body time to heal. It is important to stay positive and keep your eye on the prize - an active lifestyle.

I'll leave you with our recovery guidelines. They refer to THR recovery but your recovery from fracture and pinning is very similar.

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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​

elevate​

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Reno Cyclist]

@myglasshalffull Thank you. What was your injury?

 

[Reno Cyclist]

I can’t thank you enough for this valuable information. I truly appreciate it.

 

[Eman85]

Like:
1. Researching hip fractures turned up scary stuff. 1 in 3 hip fracture patients die within in a year? OMG. Why? How do I reduce the risk of that happening?

Obviously that is mostly people much older and you can reduce the risk by staying alive and ambulatory

2. What should I be doing now (or not doing now) to speed healing and recovery? Just follow the four minor exercises I was given (a sheet meant for THR patients)

For right now I'd say just resting and getting your bone to heal

3. Are there dietary supplements I should be taking?

My opinion which isn't worth much, your food is your medicine. Eat what makes you healthy and helps bones to heal.

4. How long until I can walk?

Don't know. I had my hip pinned for different reasons when I was a teen. 3 mos non weight bearing was the order back then. I haven't been in my teens for almost 1/2 century so things change.

5. Looking in the mirror, it appears the hip that was operated on is literally two inches higher than the other hip. ?

Give it time to settle.

6. Will I ever run again?

Maybe, I ran plenty after hip pinning and then a lame attempt by a butcher to remove the pins.

7. How long do I have to wear these compression socks?
8. Are there resources for dealing with what I know I will experience: lack of fitness, and the mental benefits that I always derive from long swims, bikes, or runs?
Well, thank you to anyone who listens and wishes to comment or provide advice. I really am all ears and hoping to learn from your experience and expertise in something new, foreign and pretty scary to me!

I'm guessing you broke your femur and that's what is pinned. Just from what I have read on this forum pinned femurs can lead to AVN. Since you weren't displaced it's a lot different than a THR.

 

[myglasshalffull]

Reno,
My injury was a fractured femoral head.
I'd look up Fractured Neck of Femur/Pinning Hip Pinning after ski accident and read, Snoopy55's account of hip pinning cause she had skiing accident.
There are a couple others that had hip pinning as well, my injury was a replacement.
I just remember Snoopy cause we were recovering around same time last year, not sure if she checks in still or not

 

[Brucelily]

I am the same age, 53 and 12 weeks post operation with 3 cannulated screws for a femoral neck fracture, slight displacement. If you need any support, here to share and help...

 

[ljpviper]

Hey Reno, sorry to hear about your injury. Just curious I have a replacement on my right side. Recently started hitting the mountain bike parks here in Miami. They have man made climbs nothing like out west. My fear is falling as you did on my replaced hip.

Was yours just a freak fall, not sure how aggressive of a rider you are and the terrain you ride in. Good luck with your healing.

thanks, Larry

 

[Reno Cyclist]

I am the same age, 53 and 12 weeks post operation with 3 cannulated screws for a femoral neck fracture, slight displacement. If you need any support, here to share and help...

Thanks. Did you have a crash or accident causing the fracture? I just saw my surgeon for the first time and was told four more weeks of non weight bearing as he wants the bones to heal more before PT. I was expecting that, but deep down hoping to be told I could start some exercises. Great expectations, I guess.

 

[Reno Cyclist]

Hey Reno, sorry to hear about your injury. Just curious I have a replacement on my right side. Recently started hitting the mountain bike parks here in Miami. They have man made climbs nothing like out west. My fear is falling as you did on my replaced hip.

Was yours just a freak fall, not sure how aggressive of a rider you are and the terrain you ride in. Good luck with your healing.

thanks, Larry

Everything out here is climbing or descending, with lots of elevation gain involved. My crash wasn’t anything spectacular; I was finishing my ride and heading into the parking lot when I hit some gravel in a rut on the access road. Instant endo, and I just landed perfectly on my hip. I impacted a rock hard berm squarely on the hip. So I think after 25 yrs of mtb, and probably over 100 crashes, this was freak in the way I landed. I’ve never even bruised a hip in a crash. It’s always shoulders, wrist, knee, back, head, you name it.

 

[Reno Cyclist]

@Reno Cyclist Welcome to BoneSmart! So sorry about your accident! The good news is that you will get back to active living again. The key is don't push through anything and give that hip time to heal before starting any training.

1. Researching hip fractures turned up scary stuff. 1 in 3 hip fracture patients die within in a year? OMG. Why? How do I reduce the risk of that happening?

Sockeye is right - in incidence of hip fractures in elderly patients is high. Unfortunately many suffer complications due to other health issues while trying to recover from major trauma. Please don't worry - you are young and healthy.

2. What should I be doing now (or not doing now) to speed healing and recovery?

There is literally nothing you can do to speed healing and recovery. Patience is the biggest challenge especially for those who have been very active. Once you are released to bear weight on that hip, walking is the best exercise.

3. Are there dietary supplements I should be taking?

No, supplements won't really impact any healing.

4. How long until I can walk?

Did the surgeon impose weight bearing restrictions? Be sure and clarify this with their office.

5. Looking in the mirror, it appears the hip that was operated on is literally two inches higher than the other hip. ?

Swelling and soft tissue trauma. Please don't worry about this. It will all ease with time.

6. Will I ever run again?

Another thing to discuss with your surgeon. Only they know what condition that joint is in and they will be able to monitor how it is healing.

7. How long do I have to wear these compression socks?

Another question for your surgeon. Some patients have to wear them for 6 weeks post op. Then there are others who don't require them at all. It's really surgeon dependent.

Your fitness level may decrease as you allow your body time to heal. It is important to stay positive and keep your eye on the prize - an active lifestyle.

I'll leave you with our recovery guidelines. They refer to THR recovery but your recovery from fracture and pinning is very similar.

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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​

elevate​

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

Thank you very much. This is useful information. I’m now two weeks post accident, and really have no pain to speak of. Funny thing, I think a lot of the pain I have now is secondary (shoulders hurt from the walker, armpits hurt from crutches).

I had a positive visit with the doc yesterday. He sees no reason why I won’t make a full recovery. Now it is being patient with my hip by not overdoing anything and continuing to stay off of it. So four more weeks of non weight bearing.

 

[Constanze]

Sorry about your accident, @Reno Cyclist . However, I'm sure you'll run again, if anyone tells you otherwise, forget all about it. I finished a half Ironman after my hip replacement and two full marathons. In 2019, I broke my tibia head, strangely enough, on the same side as my hip replacement (left side), after a fall off my bicycle which I was riding relatively speedily but in the dark. They put two metal plates in. Ever since then, I've done the full 42 kilometers again, three times, slowly though this may have been, but I'm working on my speed. The prospects for you are good Best wishes Constanze

 

[Blueyonder]

Hi Reno Cyclist,

I could have written your post, with the exception that I am 62 and wasn’t cycling at the time of my accident. Whilst waiting on the ward for my surgery on 14/5/2023, I trawled the internet and frightened myself to death with the statistics. However, I looked at all the over 80 yr olds around me on the ward and I took a deep breath…

Because of my level of fitness, general good health and good bone density, my surgeon agreed to me having 3 cannulated screws, as I wanted the best chance of going back to what I had before, I.e. my own hip, but mended. It’s tedious, as it’s the option with the most onerous rehabilitation (well, apart from doing nothing, which is bed rest for 3 months!). The other options all allow weight bearing, pain permitting. I have been instructed to minimise weight bearing as much as possible for 6 weeks and then introduce it gradually for 6 weeks after that, but to motivate myself to do non weight bearing exercises to keep muscles working and maintain good blood circulation. I’ve been told that good ways to exercise after the initial 6 weeks are static/exercise bike, gradually increasing the resistance and walking neck deep in the swimming pool and gradually lowering the depth over time. It’s all about giving as much time as is needed for the bone to heal itself, as the screws are just offering some stability whilst it does.

There are only 2 real risks for us, non union of the bone and necrosis due to lack of/reduced blood supply, but these risks are smallest with cannulated screws and a non or minimally displaced fracture - and probably a well motivated patient.

The loss of independence hit me hard and I was a pain in the **** for a week after discharge. I’ve accepted now, that I have to give myself the best chance of full recovery by being compliant. We are going to France on holiday for 6 weeks on Monday and I have bought a wheelchair, so I can get out and about more easily and enjoy my holiday without putting weight on my hip. It was supposed to be 6 weeks of hiking but that will be for next time.

Take care of yourself and you’ll be running/back in the saddle soon.

 

[AussieRodney]

I was also going to suggest walking in deep water. You might also consider "doing nothing" for some of the time. By that, I mean rest with the hip elevated if possible (even just a little) and icing the area, enough to cool the area.

 

[Brucelily]

I am the same age, 53 and 12 weeks post operation with 3 cannulated screws for a femoral neck fracture, slight displacement. If you need any support, here to share and help...

Thanks. Did you have a crash or accident causing the fracture? I just saw my surgeon for the first time and was told four more weeks of non weight bearing as he wants the bones to heal more before PT. I was expecting that, but deep down hoping to be told I could start some exercises. Great expectations, I guess.

Hi Reno, I had a skiing accident which caused the fracture (it was displaced slightly) and was operated in France. I am now 13 weeks in and have progressed to walking in 1 crutch which has been heartening. I'll be walking without crutches in 2 weeks time.

It has been a lengthy road so far and I am still uncomfortable when moving at times in particular the hip flexer.

 

[Charlie33]

Hi @Layla recommended magnesium as a supplement which helped. Can quite remember at what point during recovery. Have tagged so she can chime in.