Dr. Timothy K. Durnin - 5/1/2009

Question
Hi,

I broke my femoral neck about 12 years ago, at the age of 25.  I had a pin put in with a plate down the side of my femur (the x-ray looks like a sliding hip pin).  The surgery and recovery went smoothly and for the next 10 or more years I had only occasional minor pain in my thigh that lasted a few moments (as I shift weight from my bad leg) or a few days.  I spoke to an Orthopod a couple of years after surgery, who told me my femur was reacting to the hardware, especially with impact, and that it was best to live with it if I could.  I've heeded his advice for the last ten years though it has prevented me from participating in many activities.

Last summer after a long bike ride (30+ km) my leg 'flared up', deteriorating over the course of a week or two to the point where I was unable to bike and could barely walk. I had numerous tests, x-rays and bone scan done at that time.  By the time I was able to see an Orthopod, five weeks had past and the leg was on the mend.  The tests indicated bone inflammation, again due to reaction to the hardware.  This surgeon, however, told me he would be happy to remove the hardware at my convenience.

Fast forward about 10 months and I'm back to where I was last summer.  After doing some fairly moderate hiking and a slightly longer bicycle commute than usual, my leg has deteriorated over the last two weeks.  Now I am having difficulty walking and am popping acetaminophen and ibuprofen to lessen the throbbing pain.

Anyway, I have three questions:

1) I am assuming the leg will heal again as it did last year.  Is there anything I can do to speed up the process?  (perhaps prescription anti-inflammatories?)

2) Are there major concerns at this point regarding surgery to remove the hardware?

3) If I have surgery, it is likely that my leg return to the condition it was in before the fracture and hardware was put in, or is it more likely that will I return to life with occasional minor pain?

Thanks!

Answer
Hi Stephen,

Even if you didn't have issues with the hardware, it is recommended you remove it. Metal and bone expand at different rates when weather pressure (atmospheric) changes occur causing different amounts of pressure on surrounding pain sensitive tissues as they expand and contact at different rates. Removing them will save you much grief in the future, The procedure is very benign and carries extremely low risk, I would do it!
The leg should return to pre-injury status as long as the fracture line didn't go through or into a joint or articulation at the hip or knee. If it did, take 3 grams of OTC glucosamine sulfate with MSM for life to prevent the possibility of ever getting osteoarthritis or at least minimizing it.

Good Luck!

Dr. Timothy Durnin
lansingspinaldecompression.com