Acetabulum Fracture from Mountain Biking Accident

[Mini724]

Hi,

My partner (aged 25) fractured his acetabulum and pubic rami back in August 2007in a mountain biking accident. He had the acetabulum fracture pinned and plated. He has been told that the x-rays look really good and the only worrying thing is a small cyst which, if it fills back in, will be fine but, if not, he may need a hip replacement within a couple of years.

He has been getting some physio on the NHS but the sessions seem very few and far between. What amount of physio do you think he should be receiving for this injury?

He has been off crutches for just over a month now and has a very prominent limp.

Will an exercise bike be a good way of getting his hip moving more freely?

He still really struggles with simple tasks like putting on shoes and socks.

Also, he is worried that he has ruined the rest of his life, i.e. he used to be a very keen hill walker but now worries that he will never be able to do this again. What are your views on the levels of activity he will be able to undertake in the future.

Many thanks for your time

Chris

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[sarahwatt]

Obviously, it is really hard to give solid advice over the screen, but a few ideas for you....
-Exercise bike sounds great, no impact, and will improve ROM and strength
- Stretches, as getting shoes and socks on sounds more like restriction.
- How are his scars? Might need some scar tissue massage
- A really good idea is hydrotherapy. Especially for his gait, and if he has pain. This basically takes away gravity, which make it a lot easier for him to concentrate on improving his gait. The longer he walks with a limp, the harder it is to get rid of it, plus all the added stress he is putting on the other side and his back. It's also a really relaxing way to do some stretches, and if you have a few floats, can do strengthening exercises as well.
Hope that helps a little!

[Mini724]

Thanks very much for your reply.

I have just booked a private consultation with a physiotherapist who has a hydrotherapy facilities. He's going to do the initial consultation for free and see what therapy will need to be undertaken. He said he may be able to just show us what to do in the hydrotherapy pool and we would then be able to do this ourselves in a normal swimming pool. He said he obviously can't tell me anything yet though until the consultation.

[sarahwatt]

That sounds very sensible. Good luck!

[Mini724]

I just wanted to say a quick thanks to Patricia who sent me a personal message regarding this.

I have been on holiday and just saw the message on my hotmail, but when I came on here to reply to it, it was not in my inbox.

Your story was very inspiring. Thank you, it has given my partner more hope that things will get better.

x

[steves]

Hi,

I recently fractured my acetabulum (Sept 2008) falling from my road bike. Like your partner the fracture was pinned and plated. I would be grateful for any advice or words of wisdom from your (or anyone else's) experience.

I am 54 yrs old and was a keen competitive cyclist and am holding some little hope that I might still be able to return to this. I am currently non weight baring and for interest the fall was at slow speed while commuting (12 - 15mph) but my feet were clipped into the pedals

Steve

[mseries]

Hi,

I recently fractured my acetabulum (Sept 2008) falling from my road bike. Like your partner the fracture was pinned and plated. I would be grateful for any advice or words of wisdom from your (or anyone else's) experience.

I am 54 yrs old and was a keen competitive cyclist and am holding some little hope that I might still be able to return to this. I am currently non weight baring and for interest the fall was at slow speed while commuting (12 - 15mph) but my feet were clipped into the pedals

Steve

Steve,
I was directed here from (I think) Mini724s partner who i have been in touch with since I broke my acetabulum in a road bike crash. I broke mine in October 2007 and was plated and pinned. I am 43 years old now, at the time of the crash I had done about 7700 miles in 2007 to give you some idea of my level of fitness. I completed PBP in August that year in 81 hours.

Just over a year later I am back on the road, done 3800 miles so far this year with rides up to 200 miles in 16.5 hours. I started on the road in March this year after about a month of turbos and gym bikes as part of my rehab.

email me to talk about specifics if you want to. I hope my short story above gives you some hope.

Good luck

martin

[angela1]

After 12 weeks 9as long as the fracture has defintely healed) I would see a physio who has M.E.T training. they will do a pelvic assessment and try to correct any abnormalities. I treated a guy who's motorbike had a serious fight with a car. he was basically 'put back together' again. He was able to tie his own shoe laces and walk without a limp after I treated him with Muscle Energy Tecniques - they are so gentle.

[shamsuthbegum]

Thanks for the reply and the posting looks very good.....
...........

[guenter]

hello,
first, sorry for my bad english, i am german - from germany. but i also had an bking accident and acetabulum fracture in may 2008. and because these accidents are few, i also search about results in other countries. you also can contact me directly with e-mail, not only in this forum!
i am very interested to learn about the results of operations. i can say, that also two-and-a-half-years-later i feel development in that what i can do. so be patient - have hope!! it really takes a long time. i also needed a wheel-chair in the beginning, and today, most don't see what once occured. but what interests me is, how we can continue in sports after such an accident. i found no clear opinion of the doctors. on said: you can start jogging again - the other. oh no, never jogging again. (i did jogging before this accident.) 1 year after the accident i rode a bike for the first time again; meanwhile it's no problem.

[physiobob]

This really depends on the alignment of the bones. If they are in the right place then normal activities can continue. If there is a jaggard edge to the fracture union this will smooth somewhat with time and the pressure of weight bearing. If you have pain and the alignment isn't great then perhaps consider surgery to place a cap in the fossa and/or a resurfacing of the hip like that done by Derek McMinn. I have had young athletes with hip resurfacing surgeries so on to Olympic level volleyball and judo! If you have any x-rays or MRI images please do post them for us to take a look at.

[shiany]

Hi:

Im currently in hospital having fractured my acetabulum, ive been in now for 18 days with traction. The doctors are hoping the bones will just knit back together but this wont be assessed until I have an xray or ct scan on day 28. Really hoping that I dont have to have an operation, and am really worried about how this will affect me in the future as im a walking, biking and yoga fanatic, and finding being tied to this bed excruciatingly difficult. Ive also fractured a few other bones in my back.

Any advice please?

[guenter]

hi shiany, walking + biking will be no problem, that's what i still can & shall do instead of jogging, what i did before. you can contact me also in germany via email. best wishes!

[kathonfire]

Hi PhysioBob & members,

It has been such a challenge trying to find anything on the net regarding rehabilitation for acetabulum fractures, and I thankfully just came across this thread.

I am a very keen cyclist, just had a baby at the end of June and was back on my bike a week after my baby was born. It helped me immensely get back to my pre-pregnancy shape and I was building my level of fitness quite rapidly back to pre-pregnancy/endurance/competitive level that I was at.

Anyways 2 months later (24 August 2011) I was on my bike and got hit by a car. I fractured my right acetabulum in several places, with displacement of over 5mm. This required immediate surgery to pin and plate it all back to place.

It is nearly 3 weeks later. I am on crutches touch-weight-bearing on the right leg for about 6 weeks, then review of 4-6 weeks half-weight-bearing.

As I am such a sporting freak, like most of you that I have read on this thread (so I empathise with you all ALOT), I am going INSANE not being able to do much. I just joined a gym and am doing upper/supported machine weights & some core work every second day to try and keep some strength and to make it easier to rehabilitate my lower half when the time calls.


Knowing this basic background about my situation, my question is, when do you think I would be able to start some form of basic rehab/movement/strength work on the lower half of my body?

Assuming my scar is healed completely (which it almost is already), would I be able to get into a pool at this early stage still on touch-weight-bearing? To do some resistance work and even some swimming with a float between my knees so I don't use the hip area too much?

Also, when would you recommend I would be able to get back on a stationery bike for some non-impact resistance using the hips/legs?

Any information about when you think I would be able to do some form of cardio/non-impact based work would be so greatly appreciated! And suggestions on what type of stuff as well!

Thanks so much. And thanks guys for this thread, so grateful right now.

Cheers,
Kath

[shiany]

Hi there Kath:
Oh gosh, I do sympathise with you and wish you well.
My situation was a bit different to yours I didn't have surgery, my incident was in January where i was kept in traction bed bound for some time, and had fractures elsewhere. But just to give you some info, i came off my crutches the end of june, started swimming, i joined the gym around 4 weeks ago and have started light jogging and leg/hip weights, even though this is painful, but not too bad, and bearable. Pilates is great for strengthening too and I did undertake a short course with my physio.

I would certainly speak to your physio/doctor before getting in the pool, as if your wound is open slightly then there is a risk of infection. Maybe try a bike trainer, at least that way you can get on the bike in the comfort of your own home, you can buy them pretty cheaply on-line.

Good luck and let me know how your getting on :-)

[Jolyon P]

Also sustained a (stable) fracture of my acetabulum early September in a minor cycling accident whilst clipped in - seems to be a common theme here. Would be very interested to hear how others with similar injuries have fared and if they can cycle again. Also very keen to learn of any protective measures they now take.
Thanks in advance

[Dmayer]

Man i am amazed. Last october i also had a cycling accident and broke my pelvis and my acetabulum. After plates and screws I am still recovering andnhave hope to donsome sports in the near future. i used to cycle, run and occasionally do some rowing.

now its jan and It goes very well, i can stand on my right leg 50% without any pain...off course i am still walking on crutches. Progress is sssllooowwww and the longterm outlook is not positive for these kinds of injuries. At 36 i am not yet looking for a new hip.

It is very difficultmto find any thing about experiences of others....i want to start cycling again...hopefully some running. Although i already finished a marathon in 2011 so thats luckily already of my list:-).

I am looking for some more experiences of the recovery...what is smart to do and what not...and if i start with sports early on...will my hip hold it...ormwill it wear out in a few years...

Thanks for any reply.

Dimitri

[Jolyon P]

Hi Dimitri
Sorry to hear that you have suffered the same injury. In my case I had a stable fracture requiring no plating and after ten weeks I was able to walk again with little pain and after fourteen weeks I can now walk 15k with hardly any pain. I found that my local gym (which I joined to try to keep some fitness) had two exercise machines which really helped - these were the ones that focused on the abductor & adductor muscles. I have not got back on my road bike yet but will be doing so in the next week if the weather permits, however I can do 130rpm against a reasonable resistance on an exercise bike so it is only the psychological hurdle to overcome. I think that I have beaten the odds somewhat to have made such a good recovery and hope that you do too.
Jolyon

[Dmayer]

Hi jolyon,
That sounds quite good: 135 rpm. How longsince the accident? I am positive of mind, like most sporty people. But this injury is pretty awefull. Instill need some time now and then to rethink the consequences for the future. My favourite sport is cycling...if i can do that again i am happy. Running was more out of convenience of time needed.
Based on the stories on this site i just ordered a home trainer to practise daily...did it one time In the gym as a tryout, but until mid feb imam not allowed to drive.
Take care.
Dimitri

[Jolyon P]

Hi Dimitri
It is 115 days since I fell from my bike on a very slippery bit of road at about 10kph with the full impact being taken by my hip, even so I think it was unlucky for me to break my acetabulum so badly. I was lucky in that all the broken parts actually stayed in place so were in the right place for setting. The haematoma caused by the injury was incredible and the pain i would rate at 7out of 10 however I was always able to sleep at night. Like you, cycling is my passion and I spent lots of time worrying whether I would be able to do it again. I also spent considerable time looking for cycling shorts that would protect me in the event of the same fall happening again. I will mot ride clipped in to pedals until my conficence has returned and will think twice before going out on wet roads.How did your accident happen?

[Dmayer]

I was doing a quick round of 60 km and was on my way back home when i suddenly woke up in an ambulance. The story was that i hit a pole standing in the middle of the cyclists road to prevent cars from entering. Apparently i smashed into it with my right knee. Very odd was that my bike was not damaged, and i hardly had any scratches besides my knee. I am riding with 4 seasons tyres since i fell in the past when it was wet. Works for me eventhought they are a bit heavier.

[mseries]

Hi all,
It's been over four years since my broken acetabulum and I have been discharged by my medical team after annual checkups for the last three years. I am posting to give those of you who are currently undergoing recovery some hope. My recovery and rehab went well, no complications. My cycling life is back to normal, if anything I am riding better than I did before, due I think to the benefits of gym work. I continued stretching, weights etc after my recovery and adapted my routines to cycling. Running is out of the question for me, it hurts too much. No skiing, football or basketball or anything else that involves twisting or the risk of it. The damage to the side of my hip was such that the repair isn't 'as good as new'.

Don't lose hope, don't rush the recovery either. I was meant to be non weight bearing for 3 months post op. but I took my baby steps after 2.5 months. It was five months before I rode on the road but did one month on the turbo trainer before that.