Femoral shaft and radius - major wreck

[rossi]

So last Saturday I rounded a corner on a wide dirt track between trails to come face to face with a pickup going way too fast and completely on my side. We ended up going head on with the impact at a slight angle to the right which corresponds to the injuries.

I won't bore you with the full details but fortunately the ambulance was there very quickly and I received excellent care.

The end result is a severely fractured left femoral shaft and fractured right radius. This was repaired with 6 hours of surgery by plating the radius and inserting a rod down inside the middle of the femur with screw attachment at either end. On top of this is severe bruising on the right leg which prevents me using it for anything useful even after a week - it was actually more swollen then the left leg earlier in the week. The left wrist may yet have to be x-rayed as I have restricted movement and as much pain as the right.

The recovery timeline from date of accident:
1 week - I am now at home which is great but wheel chair bound. In a few days I will go in to have staples and stitches removed, arm cast changed to a plastic splint and x-rays to assess progress.
3 weeks - The right arm will be strong enough to weight bare and I can get on to crutches
6 weeks - crutches can go as the rod will have sufficiently fused to the bone at either end to support my weight
6 months but confirmed by x-ray - the femur should have regrown into the gaps and be sufficiently strong for me to begin athletic activity.

So a long road.

Things I can be fortunate about:

I am still alive and will make a full recovery

My body armour did exactly what it needed to and because of its design the medics did not need to cut it off me as the parts are all attached with velcro. Forcefield adventure harness if you want a recommendation.

I was wearing ortho knee braces which means I still have knees. Mine were Alpinestars B2 pro-carbon. The right brace appears undamaged but the majority of the bruising on the leg coincides with the position of the brace. Given extent of the bruising I am confident that it saved my knee. The left brace broke through the frame but again the knee is fine.

The future:
The bike damage has been reported as front wheel, plastics and a rad. I have spare wheels but I would want to check the forks and frame very carefully before deciding whether the bike is repairable and also replace the head bearings.
From a personal point of view I have not decided whether I will ride again or hang up my helmet. I have to consider the impact of this on my family and, if I find another activity to replace riding why give them the stress. Another option would be to swap to a trials bike which would only be used away from 4 wheel vehicles.

So has anyone gone through a similar smash? How was recovery?

If not I will update from time to time with progress reports.

 

[john r b]

I do not... Holy smokes that looks painful. I hope you have a speedy recovery.

 

[hadfield4wd]

My buddy did 20 years ago. Last year he had to have the rid removed due to needing a hip replacement lingering from the original accident. Took him a while but is a great rider.

He still rides aggressively. Oh and he’s 38

 

[rossi]

My buddy did 20 years ago. Last year he had to have the rid removed due to needing a hip replacement lingering from the original accident. Took him a while but is a great rider.

He still rides aggressively. Oh and he?s 38

That's good to hear, except having to go under again to have the rod removed. I expect it is a less traumatic process than inserting it in the first place as it doesn't involve the initial break and associated collateral damage.

Do you know how serious his was? Obviously it takes a lot of force to break a femur, but I have read that the greater number of breaks / parts the more serious the injury. At the bottom of the scale is a single break into 2 pieces, I appear to have the 2 ends plus at least 8 fragments which all have to hopefully grow together, providing they still have sufficient blood supply.

 

[rossi]

I do not... Holy smokes that looks painful. I hope you have a speedy recovery.

Thanks John

Fortunately the ambulance was at the scene quickly and the drugs were very good

The first couple of days in hospital i don't think the hospital staff appreciated that the muscles in the right leg were almost as shot as the ones in the left - in fact they were actually more swollen.

A week in and the right leg is not back to normal but i can happily stand on it alone. The left is not so good obviously but, sitting in my wheel chair I can bend it to 90 to rest the foot on the rest and extend it close to 45 in front without assistance. To get it further I can hook my right foot behind it to provide the additional power.

Pain meds are limited to paracetamol and naproxen for inflammation. What pain i have is, i'm sure, mainly down to the muscle rather than the bone itself. Just got to keep it moving and work it as much as I can so i don't lose too much strength and mobility

 

[Moto7man]

Take it easy and get well soon!

 

[RBrider]

Really happy to hear it wasn't worse. Hoping you heal as quickly as possible.

Staying on top of the PT, including moving it as much as you can, is probably a good idea.

Also, good to hear you're not using excessive pain killers. Some times we begin to like them too much.

Keep us posted on your progress if you will.

RB

 

[Jeff B]

The rod does not have to be removed unless it is causing problems....pain. I have a rod in my leg since 2011. Still ride, hike and go through airports without problems. Expect to limp for about a year, not because of pain, but because your normal walking gait will alter from not walking normally. Good luck in your recovery and don't rush it.

 

[RBrider]

The rod does not have to be removed unless it is causing problems....pain. I have a rod in my leg since 2011. Still ride, hike and go through airports without problems. Expect to limp for about a year, not because of pain, but because your normal walking gait will alter from not walking normally. Good luck in your recovery and don't rush it.

Regards the limp. My friend just had a hip replacement about 2 or three weeks ago. His PT told him to use a a cane even if he doesn't feel that he needs it as the cane will help him walk with his body extended to full height and hopefully avoid walking bent over or with an altered gait as he recovers.

RB

 

[hadfield4wd]

That's good to hear, except having to go under again to have the rod removed. I expect it is a less traumatic process than inserting it in the first place as it doesn't involve the initial break and associated collateral damage.

Do you know how serious his was? Obviously it takes a lot of force to break a femur, but I have read that the greater number of breaks / parts the more serious the injury. At the bottom of the scale is a single break into 2 pieces, I appear to have the 2 ends plus at least 8 fragments which all have to hopefully grow together, providing they still have sufficient blood supply.

I don’t know how serious his was but he broke his hip and pelvis at the same time. Thats why 20 years later he had to get a titanium hip.

 

[rossi]

I don?t know how serious his was but he broke his hip and pelvis at the same time. Thats why 20 years later he had to get a titanium hip.

Pelvis is bad, particularly as it causes serious internal bleeding and is often linked to lower spinal injuries.

It is likely that his fracture was higher than mine - between the ball and the top of the femur.

 

[rossi]

Two weeks in and I continue to gain strength. I had the stitches and staples removed yesterday. Fully out of the wheel-chair now, crutches only.

The right radius is giving me no issues at all although I still have some stiffness in both wrists.

I now have more strength in the left leg. I can lift it clear of the bed without support and am able to use it to steady myself when standing on the right or using crutches.

The next milestone should be in about 4 weeks when x-rays will hopefully confirm that I can ditch the crutches altogether.

 

[rossi]

The rod does not have to be removed unless it is causing problems....pain. I have a rod in my leg since 2011. Still ride, hike and go through airports without problems. Expect to limp for about a year, not because of pain, but because your normal walking gait will alter from not walking normally. Good luck in your recovery and don't rush it.

I had a conversation with one of the medical team yesterday which gave me something to think about. His advice was to think carefully before returning to biking or any other activity with the potential to damage the femur because, in the event of a further break, there is a very real risk of the rod becoming a spear which passes up through the pelvis and many of the internal organs. His recommendation was that it is better to have the rod removed after 12 months if I am going to return to bikes in the future.

Has anybody else been given such a warning?

 

[hamilton]

The doc told me, with the hardware in my humerus.... motorcycle racing is dangerous and that there was a real chance of shattering the bone with the hardware left in. 20 plus years of racing and still in with no problems.

We all make our own choices and take our chances when riding. Seems you have some time to decide. Best wishes for a speedy recovery, hope your back to riding soon.

 

[hadfield4wd]

Shoot,my buddy has been riding for 20 years as well with his. I think it may be time to find a sports medicine orthopedist that isn’t worried about a lawsuit. My ortho is well aware of my activities and gives me his best advice. He is also one of the ortho’s for the VT football team. He knows I want to stay active and helps me do so.

 

[PEB]

My brother had a rod put in his femur and then later taken out. Drs told him that if he were to reinjure the femur again it could be really ugly to fix with a piece of bent metal in it.

 

[rossi]

It is all a case of if's and maybe's.

I have been riding for 27 years and riding dirt for 16. In that time my only other injury has been a broken rib. Now I could ride another 20 years and never break another bone, or at least not the femur, and it would be totally fine. Or I could have a crash in a car and push the rod back through the pelvis. It's all down to luck, or lack of it. But it's something that I need to consider. That said, the injury was caused by a collision with a truck - not something that should happen if I was properly off road rather than on a connecting trail.

 

[shawbagga]

My brother had a rod put in his femur and then later taken out. Drs told him that if he were to reinjure the femur again it could be really ugly to fix with a piece of bent metal in it.

^This!!!

 

[rossi]

^This!!!

exactly my concern

 

[rossi]

Update - 6 weeks

Went for a set of x-rays today. The surgeon is happy with the progress so far and has cleared me to take weight on the broken leg, building up to ditching the crutches within 2 weeks. Still huge gaps between the bits of bone but he is happy that they are showing signs of growth at the ends and that the rod is stable enough to do its job.

I followed this with a visit to the physio who reinforced the 2 weeks to crutch free - his aim is to teach me to walk properly again without a limp and says that it is as much about teaching the brain as it is the muscles, although I think it is the muscles that will be hurting.

Other than walking I am clear to swim and use a static bike for exercise.

Back for more x-rays in 4 weeks time when I will also ask the surgeon about the long term and ask his advice on rod removal at a later date.