Femoral shaft and radius - major wreck
 

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.

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

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.

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

Take it easy and get well soon!

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

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

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.

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.

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?

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.

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.

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.

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.

^This!!!

exactly my concern

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.

Thanks for the update. Sounds like you're progressing well.

Back when I was racing MX, I had a good friend that had a pin in his upper arm( forget what that bone is called?) The rod protruded slightly up thru his shoulder. After he healed up, they removed the rod and he has had no problems in the years since then.

Hope it all works out well for you.

RB

Thanks RB

That would be the humorous - think of banging your funny bone inside your elbow.

Now I have been able to get out to the shed I have confirmed that the bike is totalled. The front rim is bent like a banana, forks bent back at the yokes and the front of the frame is bent out of shape so that the front mudguard is rubbing against the front down-tube - no saving that one. I might have some spares available at some point.

Last time I spoke to the police they said that they were going to charge the driver - even without witnesses, other than my riding buddy who was too far back to see much other than giving an approximation of my speed. The marks on the road surface were enough that they were able to confirm the position of both vehicles before and at the point of impact, as well as where they ended up. They confirmed that the driver was on the wrong side and continued to move forward after the impact with the bike.

All of this is now with a lawyer who is hoping to recover my losses (bike, equipment, medical costs and loss of earnings) as well as injury compensation. Not sure what sort of figure this will end up at though.

Medical professionals often confuse dirt biking injuries with street riding, and lump them together. The impacts and injuries are vastly different. Their recommendations often reflect this confusion.

Are you sure the steering head of the frame is bent? The forks being bent could cause the front fender to touch the radiator.
Good luck on all of it.

Heal quickly and well!
Jim


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Cheers Jim

Unfortunately the frame is definitely bent - the front down-tube is distorted.

I sorry to hear that.
What year and model is your bike?

2010 ec 300 - I need to find out what is happening with the insurance and whether I can break it to sell the parts. Shipping might be an issue though.

On a positive note I am off the crutches and only using a walking stick when the leg gets tired - I have a slight limp which increases when I get tired hence the stick. My knee is a bit crunchy as I flex and straighten it but the physio says this is due to the knee cap being pulled out of alignment by uneven strength muscles - once I build up the muscles down the outside of the thigh this should improve. Good news that this is not due to a damaged knee and the knee braces did their job.

After the last lot of x-rays the surgeon confirmed that the sections of bone in the leg are all showing signs of growth so should heal properly over time. Another set of x-rays in a week or 2 to monitor progress. The arm is fine and the surgeon does not need any more x-rays of that. I am still lacking a bit of grip strength in my hands, especially the thumbs, but this is improving.

I'm glad you are healing properly. That's a big plus.

A used frame might be a cost effective fix for you. They are pretty easy to come by in the US. Regarding the front end, it would be a great time to do the fork/front end swap so many have done.

No way I can do a frame swap unless I can track down a frame locally. The rules here prevent any vehicle being registered unless it is either a new vehicle with certificate of conformity or has been registered abroad and imported through an officially recognised port. If it hasn't got a stamp from the port authority they won't register it - this is to prevent vehicles being imported through the Turkish occupied territory.

I see.
It's good to learn what is going on in other countries, but this really sucks.
I hope that you can get some legal recompense from the person who was driving the truck.

Good Luck on all this.
Jim

Things have been moving on.

First one os the truck driver was in court where he admitted careless driving. This means that his insurance company won't contest liability. Once we finalise the losses, my lawyers will put in a claim which should be agreed fairly swiftly.

I have been making progress too, I was almost walking normally without a stick. However it now feels like I have made a backwards step. At my last x-ray appointment one of the screws at the knee appeared to be bent. Rather than risk breakage my surgeon had me in within the week to remove the offending screw, with the option of removing both screws if he felt the leg was stable enough. The good news is that he removed both screws at the knee. The bad news it that the screw had already broken and that half of it is still inside my leg. To top it off, I am back on crutches for a couple of weeks to ensure that the new bone formation does not compress, shortening the leg.

I know it is good news that the leg is stable but going back on crutches when the muscles in the leg were regaining strength is frustrating. The portion of broken screw is also a headache as it will have to be removed somehow before the rod can be removed.

It sounds like you are on the road to recovery. Have patience and don't rush things, and you should be back riding soon.
Best wishes for you in 2018!

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Thanks Jim

Unfortunately the road has taken a detour as I was diagnosed with non-union of the fracture in March.
I will be back in surgery soon to have all of the metalwork ripped out of the leg and replaced with bigger stuff. The idea behind this is that they will ream out the shaft in the bone and the fragments this creates will pack into the fracture site effectively forming a bone graft.

Fingers crossed this does the trick, but it is only about 80-90% successful.

I'm very sorry to hear that your healing process has hit a set-back. We're all pulling for you to be completely healed and back on your GasGas very soon.

Jimi

+1

Hope it all works out well for you.

RB

Thanks guys.

I had surgery last week. For the moment I am back at home with my feet up. The 10.5mm rod in the femur has been pulled and the bone reamed out to 14mm. The resulting bone fragments have hopefully packed out the fracture site sufficiently to form a graft for new bone. A 12mm rod has been inserted with a locking screw top and bottom.

I will see the physio tomorrow but the plan will be to restart the muscle rehab and wait to see what the x-ray shows in a couple of months.

I should put in the good news that my arm is working fine. I was originally having the occasional ache, but actually less than the left, and a lack of grip strength in both hands but now it seems to have settled. I have some loss of skin sensation above my wrist on the outside but no other issues.

Wow! You've really been through a lot.
I'm glad to hear that you are keeping a good attitude and working through the healing process. It sounds like you are progressing and on the way to recovery.

I wish you the best, and believe that your attitude will carry you through this long drawn out process of getting back on your feet and hopefully riding again before long.
Cheers!

Jim


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Keep on keeping on. Push forward. Prayers for a successful recovery

Still trying to push forward...

The strength in the leg is returning, slowly but steadily. I have my first x-ray and review appointment with the surgeon for the recent surgery. Hopefully it is going to show that the bone is at least beginning to heal.

Come across another snag though. A mountain-biking friend has just had a scaphoid fracture diagnosed after a fall in April. Since my left wrist still wasn't feeling right (no major issues but it was painful to put weight on it if doing press-ups etc) I thought I had better get an x-ray too. Turns out I also have a scaphoid fracture and am going to need another surgery to insert a pin, probably with a bone graft due to the delay in diagnosis.

My doc has checked my notes and it had been x-rayed back in October during the initial surgery but apparently scaphoid fractures are often very difficult to diagnose from x-ray during the first 10 days as the swelling will hold the bone fragments together. The 2 parts will only separate once the swelling subsides.

The lesson here would be to get a sore wrist checked out if it doesn't improve after a couple of weeks.

I'm very sorry to hear of your continued difficulties. I hope that it starts to get better for you soon.

Regarding your "not delaying an injury checkout"; I know what you mean.
I landed on my head during the 1999 Jimmy Jack Enduro in north Texas. It was a wet, rough, and nasty race, and I earned 1st in my class. ( I usually finished higher when it was more important to be able to complete the course, instead of being the fastest rider :D ).
Only three riders in my class completed the course.
During the race, which was very slick and rough, I did a twenty foot "Flying W" and landed on my head in the mud. My neck hurt for six months afterward, but I never went to the doctor with it.
Last year, I had x-rays for something else, and the radiologist pointed to the x-ray and said, "When did you break your neck? It was a long time ago."

I don't know how the doctor would have helped me back then, but if I'd known my neck was broken, I might have laid off racing for a while to let it heal. I just kept racing.

Good Healing to you!

Jim, the doc would have had you taking a break from riding for sure.

Good news is that I had an X-ray on the leg last week - the bone is now healing and the surgeon says it should be good to take impact exercise by the end of the year. The wrist is going to have a bone graft and pin but I'll have to wait to get that done - after 10 months a few more weeks won't hurt - and that should be ready about the same time.

For now i need to keep on with the physio and rebuild the muscles.