Noilly Prattle: It all hangs on a screwdriver

Thursday, February 20, 2014

It all hangs on a screwdriver

         Note: Although there is a wealth of online information about complications with hip 
replacement surgery, I have found it difficult to get information about problems arising from femur fracture surgery. My experience may help others with a similar problem.

       In an older post I talked about having surgery to repair a broken femur incurred as a result of a fall while doing a yoga exercise. The ORIF (Open Reduction Internal Fixation) surgery was done last February [2013] at a hospital in Prague where we were staying when the accident occurred. In my case (x-ray on right) a pin was inserted into the femur and secured with screws.

        At the time the orthopedic surgeon assured me that I would be able to walk normally again with exercise and rehabilitation. I was given some leg exercises to do and discharged from the hospital after 12 days with a pair of crutches. A check up in March indicated that all was going well and we returned to Japan at the end of the month.

        I checked in with a local orthopedics doctor who was impressed with the Prague surgeon's work. He told me to continue exercising and walking with one crutch for a while and then start walking without them. He said there was no need to return unless I experienced a problem. Little by little my leg improved and got stronger until I felt comfortable enough to road test it with a trip to Europe in September. We spent a month traveling in Great Britain, the Netherlands, Germany and Switzerland and I experienced no problems with my leg. I was even able to climb a hilly trail to a castle in the Middle Rhine River area.

        After returning to Japan in October I began to develop some discomfort in my hip in the form of occasional “jolts” of pain in the area where the pin was inserted into the top of my femur. A visit to the local doctor indicated that friction between the pin and muscle tissue was causing inflammation and he advised me to refrain from certain types of exercises, such as squats and the breast stroke in swimming that might be aggravating the friction.

        The condition, however, persisted and I began to seek second and third opinions and began to entertain the possibility of another surgery to remove the offending metal. My most recent (fourth) consultation with an actual orthopedic surgeon (the second one) resulted in my making a decision to undergo surgery to remove the pin. He indicated that removing the pin would almost certainly remove the source of the pain, but that there was a 1 to 5% risk of re-breaking the bone while the hollows from the original surgery filled in.

        There is, however, a little problem. The Japanese surgeon said he had never seen this type of pin before and would have to contact the hospital in Prague to find out what screwdriver to use to remove the screws. So, now I'm waiting to see if the Prague hospital will be forthcoming with the information.

        But, I'm something of a fatalist/realist in this case. Communication with the hospital in Prague has been difficult in the past in relation to medical insurance matters. I'm a bit skeptical that the screwdriver information can be obtained by the local hospital. That being the case I have pretty much accepted an either/or outcome. If we can figure out the right screwdriver, I'll do the surgery, if not, I'll live with the pin and learn to manage it.

walked as far as the red arrow

         In anticipation of possibly having to learn to live with my metal parts, I've been experimenting and pushing the limits of walking. The other day I ventured into the mountainous area near our home and negotiated stairs and steeper slopes using a crutch and using ordinary walking on the less demanding paths. I took a few photos with a timer to give an idea of the terrain. I am happy to report that I didn't experience any significant aggravation of the inflammation area and am thinking that if I have to live as a cyborg, well, there could be worse experiences....

our home from beginning of mountain trail

going up long steps with one crutch

up steep slope with a crutch
normal walking on fairly level trail
in red arrow area (previous photo)
on the mountain ridge

down steps without crutch


Anonymous said...

Interesting X-ray. Is that a tree I see in your leg...and buildings in your pelvis?

Can't the surgeon just have a flat-head and a phillips-head on hand? What other kinds of screwdrivers are there?

On a serious note, I can just imagine that those screws would cause some rubbing and inflammation. OUCH! I hope they can find the right tool to remove them so you can get some relief. Best of luck with that.


Noilly Prattle said...

Very observant;
x-ray shot through a window
shows the view northwards

Not holding my breath about getting the screwdriver (high tech apparently). I wouldn't want to over dramatize the situation. I'm not in excruciating pain, more of a nuisance. Even if I have to use a crutch occasionally, I can do pretty much what I want to do and go where I want to go.

Thanks for the good wishes. We shall see what we shall see. Will probably report on it again...