Broken hip

A snowHead

Hello,

I had a ski accident and broke my hip. It is a “complete femoral neck fracture” and required emergency surgery. I now have three screws holding my femoral neck and femoral head together.

There is not too much information out there from real people, with real experiences since it is a very rare fracture for a young adult (44) to have.

Has anybody ever have this and can tell me a bit of their recovery? Any insight would be really appreciated.

Thanks.

A snowHead

Hi @undine I did exactly the same thing end of November last year but through a skateboarding accident not skiing - took a very bad slam on concrete with pretty much all the impact going through my right hip. I had surgery that day and like you now have 3 pins. I'm 50 and reasonably healthy/ sporty and now just over 2 months into my recovery and pleased to say it's going well. As you say, it's a rare injury for a young adult, at Worthing Hospital where I was the nurse said they had only had 3 young adults with this injury in the past year - where as sadly and unfortunately for the elderly it is a very common and often debilitating injury.

You can see from the x-ray below that my break was more vertical than horizontal and because of this the surgeon was very cautious and told me I needed 10 weeks on crutches with no load bearing after the operation. Basically the more vertical the fracture the more potential for shear forces there are and so you have to be careful not to load the fracture too soon. Horizontal fractures press down directly onto each other and so can take loading sooner.

In reality I started to load bear very lightly after about 6 or 7 weeks because if felt ready, but I have to stress I took it very, very carefully, knowing that I didn't want to mess things up.

For the first two weeks after the op I was very tired a lot of the time and pretty much rested in bed for most of it. I was advised by a nutritionist to use protein supplements to aid in the healing. I made up my own milk based protein shakes with whey and vegetable protein powders and that worked well for me, however I know diary isn't to everyone's liking so it would be a matter of seeing what suits you.

For these two weeks I pretty much only shuffled backwards and forwards to the toilet, but after that I started to move about a bit more, though being very cautious not to bear weight on the hip. I also started doing bits of physio exercises they had given me, but only very lightly.

My six week check up showed the bone was healing nicely and that gave me bit more confidence to start to get out and about more and push on with the physio. Physio is definitely an essential part of the healing. Throughout the rehab my hip joint and bone have caused me very little discomfort but by comparison the muscle and tendon damage incurred through the injury and surgery has been very painful.

I'm about 12 weeks in now and walking with just one crutch and load bearing quite a bit, I can hobble short distances without any crutches but the muscles around the joint are still weak and so I do it in short bursts. I'm off work on sick leave till beginning of March and so concentrate on doing plenty of physio each day.

When the accident happened anyone I knew who had had surgery/ hip replacements said 'be patient and keep up with the physio' and I have to say that really is the best advice.

The prognosis is good and I'm hopeful for a complete recovery, however the surgeon has told me there is one caveat that will require intermittent check ups for the next 12 months. The head of the femur is apparently fed by a single blood vessel running through the centre of the neck. If that blood supply has been interrupted or damaged through the injury there is potential for the femur head to shrink in future and an early hip replacement may be required. They can't actually tell if that has been the case so regular check ups for 12 months are required to keep an eye on it. In my case although I had a complete break the head was not displaced from the neck and so they're optimistic all will be well, but only time will tell.

Hope all this information helps and feel free to ask any questions or private message if you want to. One of the guys I skate with is an orthopaedic surgeon and another works for a company that makes pins and hip replacements for the NHS (indeed he was in theatre when I was being treated!) so I'm doing my best to stay as informed as I can.

Oh, and as foot note, the biggest problem I have now is with my right shoulder. Using the damn crutches seems to have aggravated an underlying problem I have there and that's what keeps me awake at night, not the hip! I'm having to get physio for that now Happy

.

Well, the person's real but it's just a made up name, see?

You have no idea how helpful your answer was! Thank you so much for taking the time to answer it in such great detail.
My fracture was subcapital, right underneath the femoral head and my OS was concerned about the location. The closer to the head, the higher the chance of getting AVN.

I have been on crutches/ toe touching for six weeks now and tomorrow I will have my 6 weeks follow up appointment. I was told not to start PT till the bone has not completely healed since it a major weight bearing bone.
So far I am doing my non weight bearing exercises in bed, 2x a day, 2 sets of 10.

I have had two hip surgeries before, it took me three years to recover from them and to feel like myself again. I made a comeback because I was patient, followed instructions and did my PT.

Pain is low now but was brutal the first two weeks.

I am curious to what I will get to hear tomorrow at the appointment.

I am sorry to hear about your shoulder. Yes, shoulders, hands and elbows take quite a beating too from the crutches. I got “mobil legs” now, they really help.

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Sounds like you're getting all the right advice, hope the appointment tomorrow goes well. Keep me posted.

Out of interest what were the other hip surgeries for?

Anyway, snowHeads is much more fun if you do.

Thanks. Fingers crossed.

I had FAI and labral tears in both hips. I had arthroscopic hip surgery on both hips done, seven months apart. Took a long time to recover but it was worth it.

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That's the first time I've heard of that condition, just looked it up, interesting. It's amazing how clever treatments are becoming.

After the fracture have you had tests for bone density/ porosity? They didn't with me, but apparently you can ask for it.

Off back to bed now, having done my late night shoulder exercises Happy

It's coming along gradually, I have to do lots of movement, strengthening and stretching.

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The injury to the labrum is extremly painful and crippling. It makes your life miserable. Not fun at all. Recovery takes its sweet time and is tidious.

I did have a bone density scan a few years ago and it was ok. I have a very clean diet, and get my daily calcium and vitamins in.
Also, my OS said after surgery, my bone was nice and strong when she drilled the screws in.

I will have another test done, but since I am still toe touching I am not getting far and plus it’s my R hip and I am not allowed to drive yet.

Good luck with your shoulder.

After all it is free

Sounds like you are getting very good care and being well informed by your specialist, provided there are no AVN complications I would of thought a full recovery is achievable. I hope so.

Update

After 6 weeks toe touching my fracture has not healed all the way yet and the fracture line is still visible. No complications, which is huge!

25% weight bearing for 2 weeks, 50% weight bearing for 2 weeks, then weight bearing as tolerated for 2 weeks. New follow up at 12 weeks PO.

I am allowed to start PT now.

I am totally ok with all of it. Slow healing is better than no healing. 💪🏻

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Good for you. Looks like it'a all going in the right direction and wish you well with the recovery.

I'm probably about 6 weeks ahead of you, full weight bearing but not totally steady and with a definite 'Charlie Chaplin' style limp. It's get's less and less each day mind.

All the best.

snowHeads are a friendly bunch.

A little update on how things are going.

I was for 14 weeks on crutches full time and am now 4.5 months PO.
Inside my home I am off crutches, outdoors still on two. I am allowed to go inside the post office quickly without them but anything that requires more standing or walking than 15 minutes - two crutches.

At 4.5 months PO I can crutch- walk half a mile or walk about 50 yards without them.

I am doing LOTS of PT and progress is slow but steady. Painlevel is good, sometimes aching but in general good.

I have no complications but my bone is healing very slowly. At the 12 week check up the fracture line was still visible and not healed yet. It is healing, but slowly.

Fingers crossed for a continous good recovery.

snow reports

So how are you doing now that it's been over 10 mo PO?

57 years old, a similar type of break from a mountain bike crash and 5 weeks PO. I'm ready to start PT in about 10 days, and desperate to chuck my walker as my hands and shoulders have taken a beating, lol. No weight bearing but alas, can't help it and have been cheating... keep testing since about week 3 (very gently and cautiously though). Been doing movement exercises every day improving my range of motion. Still need a bit of an assist with a walking cane though, but hope that doesn't last long.

Level 1 Alpine Inst. and supposed to be teaching beginner's the joy of skiing. Hoping to do so by sometime in January (10-12wk PO). While my surgeon (himself a skier) says that's not out of the question (he said I definitely won't be attacking black diamond slopes LOL), your story of a long recovery (14 weeks on crutches full time) is a bit of a bummer for me, even though I know I'm a half a year to a year before I do the things I could do prior to the injury.

Hope your recovery has gone well since then, and hope mine doesn't take nearly as long!

Welcome to Snowheads, @Ezilyamuzed

. Hope it all goes well - but be patient and do what you're told!! wink

You know it makes sense.

Heh. Your message has not gone unheard....

Otherwise you'll just go on seeing the one name:

@ Ezilyamuzed,

first of all I am sorry you have to deal with this injury.
What kind of fracture did you have?
I think it's really important to not test things on your own and listen to instructions. You want to heal properly. This is a risky injury to have and many things can go wrong during recovery.

I actually wrote a blog about my recovery. I updated it very regularely as a matter fact, just today.

It might be easier to just give you the link, so you can browse around on your own.

I hope you have a good recovery. Don't rush things, it's not worth it.

www.hip-break.blog

A snowHead

Awesome, I'll take a look.

And my surgeon is awesome. I've discussed everything I have been doing with him. His main concern is that any kind of an impact may affect the screws as a vertical fracture will put more stress on screws when vertical pressure is applied. Basically, he was okay with my testing it gingerly -- stating that pain will tell me when I've started going too far. The risk is that if I slip, trip, lose balance, etc. it could very well cause a setback. In essence, it's all about avoiding risk. I do get that, and I am constantly having to tell myself to be patient, but it's hard when you're used to being active all the time.

Anyway, thanks for the link!

Oh, regarding my injury, this is my 2 week PO xray:

A snowHead

@ Undine,

I just finished reading the first part, where you discuss how it happened. It's like the broken hip came out from nowhere on a simple fall.

Mine as kind of the same. Front tire was washing out on a sharp, downhill corner and suddenly hit really soft earth which grabbed my tire, catapulting me over the bars. The strange thing was I felt something like a pop/pull in my upper thigh as I was forcefully unmounting my bike, lol. I hit the ground, rolled over while my bike leapfrogged over me, and I sat there, stunned that I had crashed, and angry over the whole thing. Went to get up and -- couldn't!

While you spoke of how painful your injury was, I didn't even realize the extent of mine until I tried to get up, and my leg simply would not take any weight. I thought I had a bad muscle pull or something. It never occurred to me I had broken anything. Called my wife and calmly said, "Honey, I have a problem. I'm lying near the top of a mountain and I can't get up." It was surreal. I had a hard time accepting I was in such a situation.

I ended up standing up after about 10 minutes, climbed on my bike, and rode (coasted would be a better description) down about 1000 ft vertical. Called a friend to come get me. It really hadn't felt any significant pain, but I could no longer stand using my bike for a crutch as my "good" leg was in pain from bearing all my weight and I simply fell to the ground (couldn't find a good way to set myself down) and laid there until my friends arrived.

It really wasn't until arriving at the hospital I felt any significant pain. Lots of discomfort sitting in a very uncomfortable plastic wheel chair (it was actually mostly my butt hurting from the plastic seat). They finally got me into bed, and there was discomfort in my leg and some pain while moving me to the bed etc. It really wasn't that bad. The doc looked me over, got ahold of the lab for xrays, and finally gave me some pain medication (at this point it was about 4-5 hours after the crash). Almost immediately after I swallowed, the tech came to get me to take some pictures.

Once on the table, as they positioned my leg for xrays -- I felt significant pain really for the first time. It was not fun having my hip/leg moved around to take the xrays as the pain meds hadn't even started to hit me yet.

I was back in the bed 15 min later and feeling pretty good as the meds were kicking in at that point. A little while later the doctor came in and told me I had surgery coming the next day as I had broken my hip. I was totally floored; I couldn't believe it!

Anyway, the point of all that was how different our experiences were from basically the same injury.

Like you, the worst part of the initial post op expeirence was sleeping. Anyway, going to go read more of your blog.....

Well, the person's real but it's just a made up name, see?

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Well, to follow up:

Week 6 post op dumped my walker for a cane. Started PT.
Week 9 I was up on the ski hill, and skied enough to test the waters and to give a beginner lesson.
Week 10 I skied most of the day and covered most of the mountain. A couple of days later I had my 10 week post op exam and xrays. Everything looked great and my doctor gave me a release to begin ski instruction again.

Still doing PT and daily strength/mobility exercises. I am not at full strength, but I'm back on the mountain and skiing like an old man (I am cautious and have placed restrictions on myself) but cruising the blues pain free! Very Happy

Anyway, snowHeads is much more fun if you do.

Just wanted to give a quick update. Had a complete hip fracture on December 31 2017, 13 months later - I was back skiing and it was great!!!

I wrote a blog with very regular updates about the recovery, including how skiing went. www.hip-break.blog

I am sooo happy to be back!

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@Undine, good work

Help!!

Broken hip

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