I recently had my 10-week postoperative check for my left hip fracture. As you can see from the image below, the fracture shows considerable healing and improvement from the earlier 6-week image (click on image to see full size):

The image on the left is the most recent 10-week image; the image on the right is the earlier 6-week image. The arrows point to the fracture line.

For reference, here is the matching CT scan of the hip just prior to surgery (click on image to see full size):

In particular, the fracture shows good bony union on the 10-week image. There is no breakdown of the fracture repair site, and no bending or deformity of the three titanium screws which would indicate abnormal stress at the repair site.

Nor is there any sign of the complication known as “avascular necrosis” or AVN, which is when the bone of the femoral head starts to die off due to inadequate blood supply (a known risk from certain types of hip fractures). If I had developed AVN, then this would have meant that the attempted repair failed and I’d likely need a second surgery for artificial hip replacement.

My orthopedic surgeon (Dr. Steve Morgan) has now given me the green light to get rid of the crutches and start walking with cane. I’m continuing my physical therapy and am now much more mobile. He’ll continue to monitor my progress over the next few months, but for now everything is looking good.

Diana deserves tremendous credit for putting up with my relative immobility these past 10 weeks, including doing all the unpleasant household chores that I used to do (like cleaning up the kitty litter).

And we’d like to extend our thanks to all our friends who have offered their support and encouragement during this challenging time!

Earlier posts on this topic:

“My Hip Injury“, August 31, 2011
“Hip Injury Aftermath“, September 6, 2011
“Open Letter to Apple: My iPad and My Hip Fracture“, September 7, 2011

As many of you know, I sustained a fluke hip fracture yesterday. Basically, I was crossing the street to my office when I tripped on something in the intersection. I’m not sure if it was a rock or a crack in the asphalt or what. I landed hard on my left hip and had a classic, “I’ve fallen and can’t get up”. My left hip was twisted in an unnatural position and I couldn’t put any weight on my left leg.

To get out of the road, I had to crawl out of the intersection to the traffic island. A passer-by alerted 911, and the paramedics took me to Swedish Medical Center, which is top-tier level 1 trauma hospital that my radiology practice helps staff.

The emergency team there was superb, including all the docs, nurses, EKG techs, radiology techs, etc.

My initial x-ray showed a dislocated left hip:

The “ball” of the femur is out of place, no longer sitting within the “cup” or acetabulum socket.

Here I am looking at my x-ray on the ER physician’s laptop:

The ER team then arranged for a “closed reduction” (relocation) of the hip. For this, they had to heavily but briefly sedate me, both so I wouldn’t experience the pain and to help relax my muscle spasm. I don’t remember much of this portion, but I do recall the IV sedation was very rapid acting. Then a lot of blurriness, then a resumption to groggy-consicousness with the ER doc telling me the hip was now back in place.

So that first step was went okay!

(Note from Diana: I was in the room for the reduction, and it wasn’t easy! Paul required three doses of the sedative to keep him under. His ER doc wasn’t able to do the reduction himself, despite a valiant effort, so he called another very muscular ER doc who was able to do it in short order. The whole procedure was a bit hard to watch, but I was glad to be there.)

The next step was a CT scan to see how much damage there was to the ball and/or socket. Unfortunately, I do have fractures of both portions, as you can see below:

Presumably, the force of the dislocation also caused the fractures.

Yesterday evening, while still in the hospital, the orthopedic surgeon reviewed the images, discussed various options, and recommended surgery. He decided that I was sufficiently stable to be able to go home on crutches, and surgery is planned for tomorrow.

One of my partner radiologists — who is also an orthopedic trauma radiologist like myself — has already filed my images in his list of “interested cases”. Basically, you never want to be someone else’s “interesting case”!