We have probably all been cautioned about a Femoral Neck Fracture (FNF) at some point in our recovery, and that is something that I certainly don't want to have to deal with, nor any of us for that matter. I think the cautions are in order since they come from our surgeons and PT staff.
However, I am only aware of 1 FNF in all of the surgeries Dr. Brooks (Cleveland Clinic) has done, (has to be close to 1500 at this point) and, from what I understand, that was an individual who was back in the gym doing leg presses at 8 weeks post-op.
How rare of an occurrence is this? Anyone here had a FNF or know of an instance?
I think this would be good info to add here for those who are considering this life-changing surgery and those of us who have just had it done.
I didin't find a thread dedicated to this topic, so I thought I'd start one and see where it goes!
We've had neck fracture hippies on this forum, they are not uncommon but it's usually due to a fall or as you stated someone pushed it at a gym too quickly.
Most patients adhere to the 6 month limitations and do well which is why neck fractures are not that common.
Chuck
One of the causes of fnf can be the surgeon nicking the femoral neck. Once again another reason to choose a top surgeon.
That is the first I have heard of that cause. How would that nick take place? Any ideas?
They normally happen I believe when the surgeon is using the cylinder cutter if they have not made the right measurements etc they can nick the next causing a weakness.
Also if the surgeon is poor and he doesn't look after the soft tissues then the circulation can also be damaged which can also cause fnf
OK, I get it. So if the surgeon doesn't use the right tool limiting travel or the right angle, the reamer can cut into the neck weakening it? That makes sense. I had just assumed that FNF's came from too much stress too soon on the operated leg.
I don't know what the main cause of fnf is but I have seen an xray when the surgeon had made a right mess of it and had badly cut the neck. But your right the surgeon has to do his job right and the patient has to be sensible!
Look up hip resurfacing (if you have a strong stomach) you'll see a number of times when prepping the femoral had where the neck can be notched.
And Danny is correct about notching, but too much activity, a fall on snow and a number of other things can cause a collapse, micro fracture or just a downright break. And if you break your femoral neck you will know it.
This is why we will ride your a$$ until you hit 6 months to make sure it does not happen, we all are heartbroken when a hippie has a major setback.
Chuck
Quote from: Manofword on January 01, 2013, 11:27:19 AM
OK, I get it. So if the surgeon doesn't use the right tool limiting travel or the right angle, the reamer can cut into the neck weakening it? That makes sense. I had just assumed that FNF's came from too much stress too soon on the operated leg.
LOL - Consider my rear ridden! This is a great place for all kinds of info.
Good! LOL ;D
We're not going to let that boogey man get your hip.
Chuck
We want the nxt picture of you back on your bike smiling - take your time - I waited a year before I started racing again.
I know of a FNF from a MTB fall at 6 months or so....had to revise to a THR.
That was enough to freak me out and keep me away from the MTB until recently.
David
Well, on Jan. 8th I had my 6wk x-ray and lo and behold, no FNF! Didn't expect one and I intend on doing pretty much what I'm supposed to do to keep it from happening. Not gonna let the boogey man get my new hip.
I had an interesting chat with a Professional PT nurse who has worked with BHR & THR patients for quite some time. As she was showing me a couple of exercises to eradicate my lingering minor limp, she told me that she is fairly aggressive when it comes to rehab full well knowing the mechanical limitations of recovery from the surgery. She said that my fears of FNF were pretty much unfounded and that she has never seen one in all the years she has worked with patients. She didn't tell me to go out and start running either. She did state that in her experience the people who have been athletes tend to have strong bones, accounting for quicker recovery times, and athletes who train aggressively have basically taught their bodies to rebuild and recover from the trauma of the surgery more quickly than those have lead a sedentary life style.
I'm not advocating throwing caution to the wind here, I'm only adding another piece to the puzzle and would be interested to hear maybe an opposing view from another PT.
John, Did Phil (or Dr. Brooks) recommend going to PT or did he just give you exercises to do on your own. I am a couple of weeks behind you and thinking about the next phase.
You also ask me the size of my components on another post. I never asked the Dr. but will find out at my 6 week visit.
A PT is a very bad choice as your information in regard to FNFs.
Why not listen to the leading hip resurfacing doctors?
Are you really thinking that a PT will know better what is good for you?
If this thread continues down this path it's going to be shutdown.
Common sense tells us that you can wait 6 months or even a year if need be.
Sorry if this sounds harsh but we're not here to advocate stupidity.
Chuck
Quote from: Manofword on January 17, 2013, 02:40:20 PM
I had an interesting chat with a Professional PT nurse who has worked with BHR & THR patients for quite some time. As she was showing me a couple of exercises to eradicate my lingering minor limp, she told me that she is fairly aggressive when it comes to rehab full well knowing the mechanical limitations of recovery from the surgery. She said that my fears of FNF were pretty much unfounded and that she has never seen one in all the years she has worked with patients. She didn't tell me to go out and start running either. She did state that in her experience the people who have been athletes tend to have strong bones, accounting for quicker recovery times, and athletes who train aggressively have basically taught their bodies to rebuild and recover from the trauma of the surgery more quickly than those have lead a sedentary life style.
I'm advocating throwing caution to the wind here, I'm only adding another piece to the puzzle and would be interested to hear maybe an opposing view from another PT.
He may have meant
"I'm not advocating throwing caution to the wind here, I'm only adding another piece to the puzzle and would be interested to hear maybe an opposing view from another PT.
"
I agree that we should take the lead from the surgeons, I know mine introduced some very knowledgeable PT's both in house (apartment actually) and outpatient. They were conservative, and the surgeon's office kept track of their activity.
Perhaps he meant "not" but still nobody should plan their care around what a PT says or does. We've actually had situations where the PT actually caused damage, this is why some doctors do not push PT, Dr. Gross does not (or at least when I got mine) prescribe PT.
Again, listen to your doctor, not your PT, not a neighbor, especially when it comes to making sure you do not fracture your femoral neck.
And with that, this thread is going to be closed.
Chuck
Quote from: hernanu on January 17, 2013, 03:48:34 PM
He may have meant
"I'm not advocating throwing caution to the wind here, I'm only adding another piece to the puzzle and would be interested to hear maybe an opposing view from another PT.
"
I agree that we should take the lead from the surgeons, I know mine introduced some very knowledgeable PT's both in house (apartment actually) and outpatient. They were conservative, and the surgeon's office kept track of their activity.
Yes, he meant NOT. I fixed his post for him. He was kind enough to write to me to explain his missing "NOT"
Good Luck to all. We all want to help, but sometimes our fingers get away from us when we type. Happens to me all the time :P
I think we have a misunderstanding going on. Manofword was only telling us what the PT had to say. We can agree or not.
I think we all know that we should listen to our surgeons first. If we have any questions about PT, ask the surgeon. None of us want problems.
We should try to be kind to each other when we are sharing our opinions. We all want successful hip resurfacings.
I unlocked the topic, but don't want this to get into an argument rather than a sharing of ideas.
Pat
Thanks Pat. That is exactly what I meant. One of the things which I've noticed, the more I read and research, is the disparity between surgeons and their recovery instructions and time frames. McMinn has a different recovery protocol than most U.S. Docs. And there are different viewpoints on FNF, it's frequency and risk. If this site were not here with its links to other surgeons and patient's recovery experience, we would only have one viewpoint. As a life long student, I always ask, "Why? I'm not a Doc, but I do understand the human body. That is why I pose these questions when I bump up against different ideologies. Everyone should follow the protocol they are given from their Doc but it is good to know these differences exist and what the thoughts are behind them even when choosing a surgeon.
I reported what a successful, professional PT told me who has experience with both THR & BHR. I'm sure there are varying opinions and I don't think I'm the only curious BHR patient who is interested in knowing why.
I have been with Dr Brooks twice and PT (ouside of the hospital stay) was not included in either of my recoveries. I asked and was told that PT for a good recovery was not needed or set up by his office - just keep doing the exercises provided
Those exercises plus the extra I've done on my own, have greatly helped my recovery!