I had a bike accident this past July 1st and resulted in a fractured femoral neck. It was repaired by 3 cannulated screws and the bone has healed very well. My problem now is that plate that holds the screws is offset some from the bone and I have a tendon that rolls over top every single step and every pedal stroke. This results in constant pain, currently managed by Advil multiple times a day and Voltaren cream… The surgeon that I have been seeing (not the one who did the surgery) is hesitant to remove the hardware, but will if I insist. He would replace with 3 small internal screws that wouldn’t stick out, but provide strength. As a second opinion went to a surgeon that I see a lot of his patients and is very good. I am a PT. He said easy surgery, and would replace the screws with calcium phosphate that would allow new bone to grow. Has anyone else gone through this surgery? Any suggestions? 54 year old, very active tennis player, hiking, wt lifting, running and cyclist.
Not that, exactly. I have a plate on my clavicle. I have zero discomfort with mine, so I’m opting to leave them in. If I was in your shoes, and the cost wasn’t an issue, I’d opt for the second opinion surgeon to do what he suggested. I would hate to have to take advil several times a day for the rest of my life.
Good luck.
Your post drew my attention as I broke the neck off my femur as a kid but I can’t help you with what you are chasing. I had two screws initially and in traction for 6 weeks. The neck was set shallow and my leg was shorter, so a few years later they cut it further down, spread it and plated it with a big screw along the guts of the neck. All hardware came out and not issues my end.
My only concern for you however is your use of Advil. I was a fiend to ibuprofen same years ago for a health issue I had and it destroyed my gut microbiome and I believe is not good for your kidneys. I no longer use the stuff and I am certainly no doctor but if you aren’t aware I’d be looking at the long term effects of using it.
Thanks for the reply. One of the reasons to get this fixed sooner rather than later is the heavy use of ibuprofen. It works great for me, but really do not want to have to rely on that for years to come. I am going to have the surgeon that I know his work fix this for me. Hoping in the next couple of weeks.
Do you have any x-rays you can post??
Do you have any x-rays you can post??
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Thanks for the images.
First up, I am an MD but not an orthopaedic surgeon. But I did fracture my neck of femur and have what’s called a dynamic hip screw and plate in situ.
I would be careful taking advice off the internet for something like this, you need to carefully weigh up the pros and cons of the two approaches you mention here.
In saying that, my surgeon did say I would want my metalware out at some point as it would get annoying, it’s been 9 years now I think and to be honest, it gets annoying but I don’t want to go through the recovery process again for having it removed. Not so much the pain stuff but more the rehab.
The DHS screw is a lot bigger than the ones you have in place and when they remove them basically you have a period of minimal weight bearing on that side to allow the new bone growth in the defect left by the screw. It takes some time to get the defect and bone back to normal strength.
That would be my main question for your surgeon, what’s the recovery time like if he does the more simple metalware removal with no new screws. Personally this would be my preferred option as long as the recovery time and risks of future fractures if you want to run etc as normal are not too bad
Good luck!
Thanks for the reply. I discussed post surgery, and I can full wt bear, cycle on the trainer as much as I want. Doesn’t want me on the road due to risk of fall. 6 weeks no tennis or hard cutting wt bearing efforts. Told me leg press in the gym would be ok. I healed very quickly the first time around and anticipate a quick recovery and less pain than I have now most likely. Also have a labral tear that I am hoping a shot will calm down.
Do you have any x-rays you can post??
So orthopedic surgeon here. And also unfortunately three weeks into the same fracture and similar hardware. The fracture has healed well. That’s awesome.
Do you see how the top of the ball of your hip is no longer round. That is the beginning of arthritis which has happened because of a condition called AVN which is all too common after this fracture. You can remove the hardware… it’s not a bad idea. But it may not relieve all you symptoms.
Do you have any x-rays you can post??
So orthopedic surgeon here. And also unfortunately three weeks into the same fracture and similar hardware. The fracture has healed well. That’s awesome.
Do you see how the top of the ball of your hip is no longer round. That is the beginning of arthritis which has happened because of a condition called AVN which is all too common after this fracture. You can remove the hardware… it’s not a bad idea. But it may not relieve all you symptoms.
AVN - has been on my mind since my initial surgery and recovery. It has not been mentioned yet by any of my Ortho Docs as far as being seen on x-ray. My left has similar structure. Should I directly ask on my next follow-up appt?
I went ahead and had hardware removed. I am 4 weeks out. I am active, riding 4-5 days a week, started tennis yesterday, and hiking easy with the dog. I am still swollen over the incision, and still sore. I had joint injection during the procedure that did wonders for 2 1/2 weeks for a labral tear, but is now back. Now you have me wondering if it is not so much a labral tear, but AVN complications? Ibuprofen managed my symptoms well enough, and less needed than prior to removal. Hoping with a little more time, pain goes away completely.
Aprexyz- Hope your recovery goes well. I was initially NWB for 8 weeks.
Best wishes for your continued healing!