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    Broken Hip

    Hi, I am 10 yrs Post, T4 complete. Fell out of my chair being reckless and did not realize my hip was broken. Recent Xray looks bad to me. But what do I know? The report says its a "comminuted (broken into fragments) sub capital (right at the ball) with numerous small fracture fragments. The top of the femur is no longer connected to the hip, and it doesn't look like this will change.

    So I have had two opinions from Orthopedic surgeons now and both have recommended leaving it alone. They felt that the risks of infection or an even more severe injury if I fell again outweighed any benefits. Surprisingly, they say i can just go on doing what I do with no limitations.

    I see a few posts about broken hips from some time back. Would appreciate any feedback from others that have had this problem. Thanks, Mark

    #2
    That is a difficult fracture to treat even in an AB person. Generally a total hip replacement would be done, but people with SCI do not recover well from this surgery, there is a risk of infection, and the blood loss can be significant. You are at risk of developing aseptic necrosis and chronic dislocation of the hip.

    Are you having AD? This is a common problem with undiagnosed leg fractures in people with higher SCI.

    While it may indeed just be best to follow you and allow you to sit, standing would not be recommended, and you may need custom seating to be sure that you don't have unequal pressures on your ischiums now.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      I'm about 10 weeks out from a broken hip. Mine wasn't as bad as yours sounds to be, just fractured at the top of my femur and has healed on its own without surgery. But I was definitely given limitations from my doctor, mainly not to rotate my leg/hip. I was told I could move my leg up and down, bend at the knee, but did not need to rotate it side to side. For example, I usually cross each of my legs in my lap to put my shoes on when in my chair and was told not to do that until it healed. Same goes for crossing my legs in the floor board of my car when I drive, etc.

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        #4
        Thank you brad 09 and SCI-Nurse for the helpful comments, although they are scary. Fortunately, I am not having any AD issues. SCI-Nurse, when you say "You are at risk of developing aseptic necrosis and chronic dislocation of the hip", did this mean with or without the surgery? I actually have a third doctor I am seeing now at Stanford and hope that he can answer my questions better. Thanks again, Mark

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          #5
          Unfortunately, both complications can occur with or without surgery. It will be interesting to see what the next Doctor says. Most of the patients that I have known have not had surgery - in fact I can not think of one that did. They did fine - just had to be a little more cautious - did not need a second fall!
          ckf
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #6
            SCI-Nurse: I hope to see a doctor from UCSF tomorrow. A big issue for me is that ever since I left rehab 10yrs ago, I have been encouraged to stand. I've got several apparatus I use for this, as well as an E-stim bike. Do you think the benefits of standing are considered adequately with a decision not to do surgery? It feels like I will start a downward slide without using this stuff. Thanks, Mark

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              #7
              I wouldn’t recommend standing since you have a fractured hip.
              Talk to your orthopedist first about recommendations for mobility issues
              pbr
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #8
                Originally posted by Madnance View Post
                Hi, I am 10 yrs Post, T4 complete. Fell out of my chair being reckless and did not realize my hip was broken. Recent Xray looks bad to me. But what do I know? The report says its a "comminuted (broken into fragments) sub capital (right at the ball) with numerous small fracture fragments. The top of the femur is no longer connected to the hip, and it doesn't look like this will change.

                So I have had two opinions from Orthopedic surgeons now and both have recommended leaving it alone. They felt that the risks of infection or an even more severe injury if I fell again outweighed any benefits. Surprisingly, they say i can just go on doing what I do with no limitations.

                I see a few posts about broken hips from some time back. Would appreciate any feedback from others that have had this problem. Thanks, Mark
                Happened to me a few years ago. Didnt find out that it was broke until a month or 2 after. I did have AD at night laying on my side in bed. Decided to tell the doctor after I noticed my leg seemed like it was getting shorter. Talked to 2 different orthopedics and neither one of them suggested surgery. I’ve been living with it for almost 3 years now I think.

                Comment


                  #9
                  The broken hip story continues. I am now about 6 months out from the sub-capita fracture on my right hip, and developed a stage 2 pressure ulcer because it has shifted weight distribution on my ischia and sitting bone. For me, the femur has not and will not connect to the hip again, since the ball was shattered in the fall. So when I sit, it gets pushed upward and does not bear weight. Swelling is persistent in right thigh. I am afraid I am reinsuring tissues around the top of the broken femur when it moves.

                  Long and short is that my would care clinic doc is urging me to get the hip fixed or I am at risk for continued pressure ulcers, which they think is more life threatening than the risk of prosthetic hip infection or dislocation. My orthopedic surgeon at UCSF will do the surgery, but reminded me of these two significant risks.

                  If anyone is aware of an SCI victim that had a hip replaced, I would enjoy messaging with them to see how it went. Comments welcome

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