All, went down on the easiest ride of the year last summer taking a left turn and instead of being able to get up and wipe myself off like everyone else I know, ended up having an intertochanteric hip fracture in my left leg. After I got back on my bike and biked the 2 miles to my car, eventually went to the hospital and got a nice Ti rod the length of my femur and two sets of screws (top and bottom).
I just started running again and am not rushing anything. Accident was in the beginning of July. PT had me spinning on the bike through august (talking 11TSS in an hour of riding), then just doing ~.5IF till October when I got the all clear from my doc. Been doing PT 2-3 times per week since the accident. Was keeping it mostly easy on the bike and only doing water jogging in the pool till around thanksgiving when I started 30s run/90s walk, progressing to closer to 1:1 ratios. Around Christmas just started continuous EZ running and pulled the plug if anything didn’t feel right (didn’t happen very much, but when it did it was the muscles being very tight and telling me, not today).
Most docs/PTs I have talked to said don’t worry about taking the hardware out unless it’s bothering me as that’s just another surgery to go back and have to recover from. I realize triathlon (do everything from spring to IM) is a little different beast from a loading standpoint. Curious on people’s long term experience with keeping or removing hardware in a similar break/procedure? For reference 160-170 lbs, 6’1", 3:30IM run, 18 and change 5k, sub 1:30 HM, 260-290 FTP, sub 4:30HIM and right around 10:00 IM
If I’m honest, I’m leaning towards not messing with it unless something starts to bother me, but I have had one person tell me that the run loading could cause serious issues if the hardware stays in there. I plan to get another opinion from another Ortho, but figured the interwebs will be just as good! Seriously though, just good to have some other data points.
You’re 6 months out of major surgery. You’re just increasing activity. Your leg/hip won’t feel normal again for at least a year from surgery. Don’t rush this healing process. You’ll have plenty of time to dissect out if it’s bothering you or not as you increase your training over months. Until it’s really a problem, leave it alone and focus on getting better. Leave the cart behind the horse.
Sorry to hear of your incident. I’m 15 years out from having an intertrochanteric fracture about 3cm below the hip socket on my right leg. Mine happened while on the bike leg of the Phuket tri. But I couldn’t get up from the road like you did. Spent almost one week in the hospital. Worst week I have ever had in that learning how to walk again was torturous. A plate and three screws were inserted into the area.
Fast forward 15 years and I still have the hardware inside. I ran a lot (1000km/year) until 2014 after which I had to stop because of knee complications from previous injuries.
I feel no pain from the area whatsoever and have not experienced any adverse effects, ie. feeling any arthritic effects when it rains, etc. Unless something drastic changes, I will leave it in forever.
Happy to discuss any further details if you want to dm me.
Hey Andrew, sorry to hear about your injury.
I am a doctor, and I fractured my neck of femur about 6 years ago. Mine was managed with a dynamic hip screw/plate. It is a little unclear to me what sort of fixation they did, if it was intertrochanteric it is likely similar to mine but the way you speak it sounds like you may have a femoral rod rather than a DHS??
My surgeon said to me that being young I would likely want the metalware out in 12-24 months as it can get quite irritating etc. I am by no means a great triathlete, but since the surgery and with the DHS in place I have managed to qualify for worlds twice (sprint and 70.3) and done one Ironman (10:4X, good swim and bike but tough run).
I have just decided to leave mine as it is as the surgery and recovery, whilst not too bad, would play havoc with my work and training life.
Just be cautious in terms of how you interpret my experience, because if you do actually have a femoral rod and not a DHS then they may want to take it out.
PS: I was back on the bike very early on, then swimming but took about 8 months until I was happy to start running again.
Thanks for the feedback guys. Yeah, I had a femoral rod with screws on each end.
My leaning was the same, let’s see how training feels and go from there to see if something presents itself that drives me into another surgery, but I wasn’t sure I wanted to sign up for going in and re-initiating another session of trauma.
Thanks for the feedback guys. Yeah, I had a femoral rod with screws on each end.
My leaning was the same, let’s see how training feels and go from there to see if something presents itself that drives me into another surgery, but I wasn’t sure I wanted to sign up for going in and re-initiating another session of trauma.
m
Yep femoral rod.
I would have it taken out.
When’s will be tough, time for the end of a season basically! Oh o
What’s the concern there, backing out under the repeated loading of miles (I do 25-65 per week depending on time of the season) or a bone strength issue due to the same thing?
What’s the concern there, backing out under the repeated loading of miles (I do 25-65 per week depending on time of the season) or a bone strength issue due to the same thing?
My orthopaedics is rusty as it was a long time ago. Mainly as it in internal rather than a plate on the cortex. It won’t change position, but it does change loading dynamics through the femur. Removal of that is not too bad actually. The DHS is worse as it has a bit cannulated screw through your neck of femur that when removed needs time for bone remodeling etc. Never an ideal time to have it removed, depending on where you are season wise and post fracture time lines. Probably aim to get it done late in the season so you have all off season to get through rehab and get for again.
Femur neck fracture. Not weight bearing for 6-7weeks then started swimming, walking, and cycling again.
Three nice lightweight Ti rods but had pain/discomfort including not being able to sleep on both sides. I got the rods removed approx 7months after the fracture.
I’ve never returned to running but I am back to same level cycling albeit my L/R balance is 1% off the numbers from before my crash.
Thanks for the feedback guys. Yeah, I had a femoral rod with screws on each end.
My leaning was the same, let’s see how training feels and go from there to see if something presents itself that drives me into another surgery, but I wasn’t sure I wanted to sign up for going in and re-initiating another session of trauma.
Nothing to add here other than my x ray looks exactly like @agreif (rod, screws, and nail but no DHS) and I’m just trying to learn how others have approached this. I’m 10 weeks post surgery and just started riding again, still not walking without a slight limp so no running. All lingering pain is in my front hip flexor/psoas. I’m 50 and am being told the hardware is forever. I’m past my IM heyday but would still like to run for fitness if possible if the hardware can take it.
21 years with my hardware. Used to run but don’t since it aggravates unrelated back issues. A few years after surgery I was doing duathlons and for years was doing 8-10k miles/year on the bike.
Thanks for the feedback guys. Yeah, I had a femoral rod with screws on each end.
My leaning was the same, let’s see how training feels and go from there to see if something presents itself that drives me into another surgery, but I wasn’t sure I wanted to sign up for going in and re-initiating another session of trauma.
Nothing to add here other than my x ray looks exactly like @agreif (rod, screws, and nail but no DHS) and I’m just trying to learn how others have approached this. I’m 10 weeks post surgery and just started riding again, still not walking without a slight limp so no running. All lingering pain is in my front hip flexor/psoas. I’m 50 and am being told the hardware is forever. I’m past my IM heyday but would still like to run for fitness if possible if the hardware can take it.
finally i see somebody with the same post surgery pain!
mid March 2022 i was hit by a car while riding and i had a posterior shift of the hip and femur fracture. Basically my hip head came out from my butt. I had 10 screws in and operation seems to be gone perfectly after several xray checks. after 4 weeks i started indoor cycling and after 7 weeks i restarted light running and swimming.
cycling even 5 hrs is never an issue
running? not pleasant because i always have this front pain in the hip and psoas area going inside the groin. Physio doesnt know what to do to make it go away but i was wondering if this is normal for a way after such operations
what did they tell you about this pain?
Thanks for the feedback guys. Yeah, I had a femoral rod with screws on each end.
My leaning was the same, let’s see how training feels and go from there to see if something presents itself that drives me into another surgery, but I wasn’t sure I wanted to sign up for going in and re-initiating another session of trauma.
Nothing to add here other than my x ray looks exactly like @agreif (rod, screws, and nail but no DHS) and I’m just trying to learn how others have approached this. I’m 10 weeks post surgery and just started riding again, still not walking without a slight limp so no running. All lingering pain is in my front hip flexor/psoas. I’m 50 and am being told the hardware is forever. I’m past my IM heyday but would still like to run for fitness if possible if the hardware can take it.
finally i see somebody with the same post surgery pain!
mid March 2022 i was hit by a car while riding and i had a posterior shift of the hip and femur fracture. Basically my hip head came out from my butt. I had 10 screws in and operation seems to be gone perfectly after several xray checks. after 4 weeks i started indoor cycling and after 7 weeks i restarted light running and swimming.
cycling even 5 hrs is never an issue
running? not pleasant because i always have this front pain in the hip and psoas area going inside the groin. Physio doesnt know what to do to make it go away but i was wondering if this is normal for a way after such operations
what did they tell you about this pain?
Sorry to hear it, sounds like a bad crash. I’m continuing with PT exercises at home really focusing on glute strength, hip strength, and hip and psoas mobility. It is getting better but I’m still not running. Anything related to glute strength seems to really help; supine bridges and isometric flexing of the glute during many other moves.
All the docs and PTs say it’s related to weak hip flexors, tightness, and to keep working on it. My hips are gradually becoming level again after having a 30mm discrepancy.
Seriously though, just good to have some other data points.