Post-Surgery Challenges: Hip Fracture Recovery Pain

Postoperative issues

Femoral neck fracture with three screws fixation.
The surgeon mentioned that there is no displacement, and callus formation is present but not yet healed.
Currently, there is external rotation of the foot, and pain in the groin area persists.
Lifting the leg to put on socks causes pain, and squatting for too long is painful.
Walking is still not normal, with ongoing pain in the groin area.
It has been over three months; why do these pains still exist, and how long is the typical recovery time?

9999, 30~39 year old female. Ask Date: 2015/08/21

Dr. Shi Guozheng reply Orthopedics

This type of pain is normal and usually subsides only after complete healing, which can take about six months.
Femoral neck fractures in young individuals should not be overlooked, as there are potential issues with nonunion and avascular necrosis of the femoral head in the future.
Therefore, it is essential to carefully protect the hip joint and to have regular follow-up appointments.

Reply Date: 2015/08/21

More Info

Recovering from a hip fracture, especially after surgery involving the placement of screws for stabilization, can be a complex and often painful process. It's important to understand that pain and discomfort during the recovery phase can be influenced by several factors, including the nature of the injury, the surgical procedure, individual healing rates, and rehabilitation efforts.

Understanding Your Pain
1. Nature of the Surgery: In your case, the surgery involved the placement of three screws to stabilize the fractured neck of the femur. This type of surgery is typically performed to allow the bone to heal properly. However, the presence of hardware (screws) can sometimes lead to discomfort or pain as the body adjusts to the changes.

2. Bone Healing Process: The healing of bone fractures is a gradual process. While your surgeon has indicated that there is no displacement and that bone callus (the new bone that forms during healing) is developing, it can take several months for the bone to fully heal. In many cases, complete healing can take anywhere from 3 to 6 months, or even longer, depending on various factors such as age, overall health, and adherence to rehabilitation protocols.

3. Pain in Specific Areas: The pain you're experiencing in the groin area and during certain movements (like lifting your leg or squatting) is not uncommon. This could be due to several reasons:
- Soft Tissue Involvement: The surgery may have affected surrounding muscles, tendons, and ligaments, leading to inflammation or strain.

- Nerve Sensitivity: Sometimes, nerves in the area can become sensitive or irritated during the healing process, leading to pain during movement.

- Muscle Weakness: After a fracture and surgery, the muscles around the hip may weaken due to disuse, which can contribute to pain when attempting to perform activities that require strength.

Recovery Timeline
While every individual heals at their own pace, here are some general timelines and expectations:
- Initial Recovery: The first few weeks post-surgery are typically focused on managing pain and beginning gentle movements. You may still experience significant discomfort during this phase.

- 3 Months Post-Surgery: By this time, many patients begin to notice improvements in pain levels and mobility, but it is not unusual to still experience some discomfort, especially with certain movements.

- 6 Months and Beyond: Most patients see substantial improvement in pain and function by the six-month mark, but some may continue to experience residual pain or discomfort for a longer period.

Recommendations
1. Follow-Up with Your Surgeon: It is crucial to maintain regular follow-up appointments with your orthopedic surgeon. They can assess your healing progress, adjust your rehabilitation plan, and address any concerns regarding persistent pain.

2. Physical Therapy: Engaging in a structured physical therapy program can significantly aid in your recovery. A physical therapist can provide exercises tailored to strengthen the muscles around your hip, improve flexibility, and enhance your overall mobility.

3. Pain Management: Discuss pain management strategies with your healthcare provider. This may include medications, physical therapy modalities (like ultrasound or electrical stimulation), or alternative therapies (like acupuncture).

4. Activity Modification: While it's important to remain active, you may need to modify certain activities to avoid exacerbating your pain. Listen to your body and avoid movements that cause significant discomfort.

5. Patience and Persistence: Recovery from a hip fracture is often a marathon, not a sprint. It requires patience and consistent effort. Celebrate small victories in your recovery, and stay committed to your rehabilitation plan.

In summary, while it is concerning that you are still experiencing pain three months post-surgery, it is not uncommon. With appropriate follow-up care, physical therapy, and pain management strategies, you can work towards improving your function and reducing your discomfort over time.

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