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  1. #1
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    Any acetabular fractures out there?

    I just got to learn the name of a body part I'd never heard of before!

    On Dec 1, I fell at the end of my usual 25 mile Tuesday morning ride. I was turning left, inside my neighborhood, and the bike just shot out from under me. My full weight hit on my left hip and then my head bounced. Thank God for the helmet!

    I quickly discovered my left leg wouldn't move. Turned out I had fractured my acetabulam, which is basically the hip joint socket. There are about 10,000 of these injuries a year in the USA, and most are from car or motorcycle wrecks. There are about 25 experienced acetabular surgeons in the USA.

    Fortunately, one of them was nearby. The local hospital transported me to where this guy was and he put it back together in a 3 hour or so surgery.

    I can't put any weight on my left leg for a minimum of 8 weeks. At the end of this, the surgeon has repeatedly assured me I will recover 100%. He says the only complication is possible arthritis in the joint from the injury; I'll either get arthritis or not within a year. It could be mild or severe, there is no way to predict. He did say he saw nothing to indicate it should be an issue, but you just can't tell.

    It's hard to know if I will ride again. The pain and fear of the fall are too fresh right now. My wife has been an angel, and while she is a bit put off by my riding, she assures me I'll ride again.

    Has anybody come back from something like this? How hard is the mental part? At 60, I had planned to ride a long, long time, but I don't want to go through this ever again.

    6 weeks and 5 & 1/2 days to go!

  2. #2
    Time for a change. stapfam's Avatar
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    Definitely not had your experience yet- but a couple of Serious? medical problems in 99 and 01 caused me a problem-----mentally. Got over the first one but the second one did hit me bad.

    But your surgeon has given you that "Bit" of hope. He is one of the specialist's and he can see no ongoing problems. Early days, I know but let him do the worrying about the cure- and not you. Of course you will have more of a physical problem to get over than I did but providing you take it sensibly and don't push too hard- thejoint will recover. It may not feel like it for a few months but certain little signs will make themselves apparant.

    The problem will be that "Mental" one though.Just face it- you have just damaged your hip joint quite severely and you have to look after it. No need to push to the top of the hill- no need to do the extra milage- no need to really get yourself as fit as you could as the hip will not let you. Cobblers. The only thing that will stop you making a full recovery is you and the negative attitude that will arrive if you let it.

    That negative attitude is exactly what I had in 2002- 2 years after the cancer op. Decided to take a "Kill or Cure" approach and entered a ride that I had previously done 6 years before. I went over the top on setting this ride as a Target as it is the hardest ride I have ever done in my life. It would take some training- in fact from the low base I was working from it took a lot of training- but I had 6 months of Cycling- gym work and organising to put me straight.

    Midsummers day in 2003 and I was back. Just finished that ride and although it was the longest time I had ever done it in- and I had never felt that shattered before- all my problems were in the past.

    So think about the ride you are going to do in 2011. Make it a hard one but don't go silly like I did. Spend the next year getting mobility and painfree- then start training for the rest of your life.
    How long was I in the army? Five foot seven.


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  3. #3
    GLA
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    67walkon, sorry to hear about your accident.

    This happened to me about 12 years ago, after a mountain biking 'incident'. Though I was only young!!, about 41yo.

    Exactly the same, no loadbearing for 8 weeks. I also had a lot of soft tissue damage, particularly around the hamstring area. I think this was actually more painful. Bit by bit I got back on the bike. I set myself some small goals and then as I got confidence and strength, the goals and achievements increased. I remember lying in hospital wondering if I would ride again and set myself a goal to ride a particular event (about 100km) later in the year. When I got to finish the event, I finished with tears in my eyes. I was really surprised how emotional it was - it had been a tough road getting there and now I was really going forward.

    The mental part was tough initially. But the goal setting in small steps helped. My accident happened on a high speed descent, so this was the area I had to work hardest at to mentally recover. This took quite a while, but another thing that helped me was working on my technique.This lead to greater confidence.

    I never really went back to mountain bike riding (just occasionally, and very slow down hills) but took up road riding. I find that if I keep fit, my weight down, and ride regularly, I have had a total recovery. In fact, I've done 8 rides, 1000km or greater since.

    Believe in the surgeon's hope (it's great you got a specialist). I understand part of the journey you have in front of you. Keep moving forward, but don't overdo it.

    BTW: I think the 8 weeks non load bearing is the toughest time because it seems like you're not going anywhere.

    All the best

  4. #4
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    Err......... Floyd Landis?

  5. #5
    Senior Member gcottay's Avatar
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    Quote Originally Posted by 67walkon View Post
    . . . . At 60, I plan to ride a long, long time, but I don't want to go through this ever again.

    6 weeks and 5 & 1/2 days to go!
    Suggested edit above. One way of the other, you can continue riding. If you have confidence issues on your bike, there are some very good trikes available.

    Best wishes for a smooth recovery and some fine late winter riding.
    George
    Laissez les bon temps rouler

  6. #6
    Senior Member ro-monster's Avatar
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    Sorry to hear about your accident!

    I haven't had a hip injury, but a year ago I crashed and shattered the top of my humerus where it sits inside the shoulder joint. After two surgeries and seven months of rehab I finally started riding again, and it was very intimidating. I took a couple of steps that helped me gain some confidence. First I took a lesson with a bicycle coach, to see if he could spot anything I was doing wrong that might have contributed to the crash. I also took a class on cycling in traffic.

    The other thing I've done is probably going to get me laughed at, but here it is. I bought an armored mesh jacket (intended for motocross) and soft T-Pro Force Field armor for my knees and hips. It's a minor nuisance getting geared up but I don't worry so much about falling. At 54, recovering from a major injury isn't trivial any more, and I would rather not lose another year of my life to an injury if I can help it. Coming from a motorcycling background and seeing how much armor helps in motorcycle crashes, I'd always wondered why cyclists don't wear any protection, and even though it's kind of embarrassing, having the armor gives me some peace of mind.

  7. #7
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    ro-tell me more about the armor. That sounds like it might help get over the initial jitters.

  8. #8
    Senior Member BlazingPedals's Avatar
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    Bike falls aren't so intimidating when you're only sitting a foot off the ground. Lowracers or tadpole trikes fit the bill.

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    I had an accident with a truck 1.5 years ago (at 45) while commuting to work -knee surgery and unable to walk for 8 weeks. I started commuting a month after I could walk again but mentally I could not ride in traffic. I drove to the bike path every day. After a few weeks I started riding on the roads again. now I am pretty much were I was before the accident. If they give you physical therapy do it religiously - it may make a big difference later on. Find out if there is a support group of forum for your injury on-line - there was for mine and it made a big difference. My doctor told me nothing unless I asked. I have arthritis because of the injury- I feel it every day but it does not prevent me from doing anything. Your prognosis is excellent, bone injury at the joint take a very long time to heal so be patient Best of luck.

  10. #10
    Senior Member Retro Grouch's Avatar
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    Quote Originally Posted by 67walkon View Post
    Turned out I had fractured my acetabulam, which is basically the hip joint socket.
    Before I read your explanation I was thinking maybe that's what happens if you have an erection lasting longer than 4 hours. I keep hearing warnings about that on TV all the time. I bet you're glad that isn't it.

    Seriously, it doesn't sound like any fun at all to me. I hope the pain subsides and you get back to normal activity quickly.

  11. #11
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    Every day (10 days post surgery now), I'm more encouraged about riding again. Thanks for the support.

    My wife and I are pretty sure the cause of the crash was related to the resurfacing of the ashpalt roads in our community. At least one kid has falled since the roads were re-done over the last few months. My wife says she was checking on the slipperyness when she was walking yestereday and reports the new surface is slick as ice when just a little wet. That encourages me because it helps explain how such a weird accident occured.

    The pain is tolerable. The inconvenience is the real pain.

    Be very careful on newly paved or resealed asphalt!

  12. #12
    Senior Member ro-monster's Avatar
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    Quote Originally Posted by 67walkon View Post
    ro-tell me more about the armor. That sounds like it might help get over the initial jitters.

    Sorry for the long delay in replying; I've been working some insane hours and haven't had much time to spend online lately. The links below are for the lower body armor. I would have bought the long pants but the legs were too long for me, so instead I got the shorts and limb tubes.
    http://www.forcefieldbodyarmour.com/pro_pants.asp
    http://www.forcefieldbodyarmour.com/limb_tubes.asp
    http://www.forcefieldbodyarmour.com/action_shorts.asp

    I did have to modify the shorts a little bit, since they don't make sizes for short women!

    For the upper body, I wanted a jacket that would go over my shirt, rather than armor that would go under it, so I opted for this:
    http://www.alpinestars.com/Stella_Bi.../p/651658.html

    There are a lot of similar products on the market, including some designed for downhill mountain biking (they appear to be pretty much identical to motocross gear though).

  13. #13
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    Well, it's now over 4 months since the accident. I developed a dvt in that leg right at the end of my 8 weeks in the wheelchair. The clot had broken off and gone to my lungs, but I had no lung symptoms, just a bunch of pulmonary embolisms. The clot bought me another week in the hospital. Finally, after about 11 weeks, I was allowed to put my full weight on that leg.

    The joint feels good. They cut a couple of muscles to do the surgery and I have a lot of stiffness and soreness. When the dvt was diagnosed, the leg was a bit swollen, but its back to normal. My knee on that leg is a bit swollen still, but the rest is good.

    I'm hoping to get back on the bike this weekend and see how it goes. I have my primary doctor's blessing and my wife's blessing. I can't actually get my good leg over the bike yet (yes, I've tried), but I think I can do it.

    This has been a long, painful journey. And while it is far from over, I think I'll be okay.

  14. #14
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    On August 8th at 9:15 AM during a 60 mile bicycle training ride I was struck head on by a pick-up truck doing 40 mph. I was actually at a stop sign in a turn lane in front of a pedestrian cross walk when I was hit. WTF?

    Doctor told me that my hip was dislocated, which fractured my femoral head, fractured my acetabulum, tore my labrum, and separated my left shoulder. They performed an open reduction internal fixation of the hip after 5 1/2 hours. I'm still using crutches, but I don't care as long as I don't end up like Bo Jackson.

    I now have to wait two years to see if I develop AVN or post traumatic arthritis, and a total hip replacement is not too far away from my distant future due to DJD. Then I'm told I will never be able to run again. WTF? I plan to live another 40 years
    , but I diodn't plan for this!

    On a more positive note, swimming has been the best psychologically and highly recommended for mental medicine. Three months post op and scheduled to swim 70.3 portion next weekend since I cannot get a refund.

    Ordered a new bike and also hope to be riding pain free before Thanksgiving on a trainer. I realize that is a tall order, but I promiss to build slow. Doctor told me he would not ride 20 miles a day. WTF? Don't these doctors know that 20 miles is a nice short ride when you really don't have any time?

    Like they say Life can change on a dime, but it's a lot more expensive now.

  15. #15
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    67walkon, Had exactly the same happen to me in Jun 2009 near the end of long day's ride when I slipped on loose gravel and fell hard while pulling off to the shoulder, except it was my right hip. Emergency room x-rays showed no fracture, but I could not take even a step so they ordered an MRI, which confirmed a hairline fracture. The orthopaedic surgeon decided surgery was not called for in my case. He said it normally heals within 6-8 weeks, to keep weight off etc., but did caution me about future arthritis risk. Good news is I was able to start riding indoor on a stationary bike within 6 weeks, and outdoors within 8 weeks. I rode Cycle Oregon 2010 last month in its entirely without any after-effect of the injury . I am 61 now. So, keep your spirits up and you will be riding again soon. All the best.

  16. #16
    Senior Member Jay Andriot's Avatar
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    I'm just coming up on my one year anniversary of a fall off of my roof, blew out my left acetabulum. Non weight bearing 10 weeks, well almost I did a lot of cheating. I did a recumbent stationary bike 3 weeks after surgery non load bearing and that helped a lot as well. After a year I am finally back up to speed and just back up to distance. Riding is easy on the hip, walking is not. The good thing about falling off of a roof is that I am not afraid to ride my bike fast, cleaning gutters is another matter.

  17. #17
    17yrold in 64yrold body
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    Quote Originally Posted by 67walkon View Post
    Well, it's now over 4 months since the accident. I developed a dvt in that leg right at the end of my 8 weeks in the wheelchair. The clot had broken off and gone to my lungs, but I had no lung symptoms, just a bunch of pulmonary embolisms. The clot bought me another week in the hospital. Finally, after about 11 weeks, I was allowed to put my full weight on that leg.

    The joint feels good. They cut a couple of muscles to do the surgery and I have a lot of stiffness and soreness. When the dvt was diagnosed, the leg was a bit swollen, but its back to normal. My knee on that leg is a bit swollen still, but the rest is good.

    I'm hoping to get back on the bike this weekend and see how it goes. I have my primary doctor's blessing and my wife's blessing. I can't actually get my good leg over the bike yet (yes, I've tried), but I think I can do it.

    This has been a long, painful journey. And while it is far from over, I think I'll be okay.
    I broke my left acetabular ring in 1980 and was in traction for 30 days after the surgery, then crutches for two months. It was a slow process, but after about a year, it felt as good as it ever did. Now I am able to ride whatever distrance my legs and lungs can stand, with no problem from the left hip.

    Good luck with your recovery, and keep a positive attitude--it will get better.

  18. #18
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    I don't know if you're still checking this but I just broke my acetabulum in about six pieces and along with a few other areas during my century ride in Maine July 23, 2011. I'm six weeks into the rehab. Can't walk on it for another six weeks. How did it all work out for you? Are you riding again? Any pain? I have no idea why I crashed since my concussion also knocked out about 1.5 hrs of memory.
    I'm terrified to get on the bike again right now as I lay here months away from actually being able to. I hope the pain and fear go away!

  19. #19
    Senior Member John_V's Avatar
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    My wife was born with right hip dysplasia (malformed acetabulum) which has caused her several surgeries since early childhood just so she could walk. She's now 64 and has bilateral hip prosthesis due to the birth defect. Her right femur has a bulge in it where the end of the prosthetic shaft is at and was told by her surgeon that if she fell from her bike and fractured the femur, she would probably not be able to walk again without using crutches. She was so afraid of falling that she gave away her bike and quit riding entirely. It took me about a month to get her convinced that she could still ride again so I went and bought her a recumbent trike (she is on her second one in less than a year) and has been putting on the miles ever since. Her surgeon is thrilled to death that she is exercising as much as she is. The pain will go away, but if the fear does not, there are alternatives to do what you really love doing and that is to ride. It may not be on two wheels, but riding is riding. Stay strong and don't give up.
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    Adambomb

    Any injury to the joint? Bones are designed to heal quite nicely but joint injury may cause lingering pain. I have a plate in the leg and the except for very rare pain due to arthritis I have made a full recovery. The mental part takes a very long time, but you will ride again. Do not rush it. I went through a 6-8 month period where I was not going to ride. The only change is that I am probably more assertive in traffic now than I was before. Do as much P.T. as you can this will help you later on.

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    Hip

    Quote Originally Posted by Adambomb View Post
    I don't know if you're still checking this but I just broke my acetabulum in about six pieces and along with a few other areas during my century ride in Maine July 23, 2011. I'm six weeks into the rehab. Can't walk on it for another six weeks. How did it all work out for you? Are you riding again? Any pain? I have no idea why I crashed since my concussion also knocked out about 1.5 hrs of memory.
    I'm terrified to get on the bike again right now as I lay here months away from actually being able to. I hope the pain and fear go away!


    I'm 49 and had a head on versus an SUV while waiting at a stop sign on 9/8/2010. Truck had some considerable speed, but lucky for me I was standing on my peddles otherwise the impact would have been on my chest rather my hip. I fractured my posterior acetabular, labrum tear, and factured my femoral head.

    These multi fractures are the wore of the worse and their outcomes are questionable. Take heart that you were seen by a tier one trauma center. I was restricted to 3 months of non weight bearing, but I started swimming four weeks after surgery. I'm in the medical field since the 1980's so with all my down time, I spent 100 hours per week researching clinical studies of what caused positive outcome in multi fractures. You have 50% chance at best with a multi facture that you will require a THR within 2 years!!!

    My recommendation 1.) get your family doctor put you on a cholesterol lowering agent ASAP, even if you don't have cholesterol!!!! since research is trending that post op results are greater with than without. Probably due to the anti inflammation properties of blood plasma. 2.) Never perform any impact exercises again, otherwise you increase the chance over time of requiring a THR. 3.) Take your time recovering, you'll be back on the bike, but only if you baby that pelvis and slowly make it strong again. 4.) Consider fish oil liquid and CoQ10 supplementation. 5.) Keep you legs elevated as much as possible since you want blood supply in that area assisting in repair.

    I swam Miami 70.3 eight weeks after surgery, of course I DNF the rest of the race. In 2011 I did a two man relay at St. Anthoney's and interestingly my bike split was one minute slower than in 2009 when they canceled the swim. I'm now up to 200 miles per week and swimming 8, but I'm off my feet. Getting to my old race weight is a real struggle since I'm not running any more, it's not that I can't, but I just want to keep what I have. My doc told me after my one year follow up that if my xrays look this good next year then my screws and plates will last a LONG TIME. That's my goal. No THR, but if it happens it happens.

    P.S.: I'm racing the Aquabike masters champs in October 2011 and trying to get a Full IM slot for 2012. Plan is to build as much time on the swim and bike so I can comfortably walk the marathon.

  22. #22
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    Good for you to be put there doing so much. It must feel good to be active. I hope the challenge of adapting tonwhat you can do and not focusing on what you cant do has not been too difficult. I'm two months in on recovery now. 2.5 more weeks to go until I can weight the leg. I've been on a recumbent trainer and a regular one a both three days a week with no resistance for about 30 min. My hip joint feels noain and range of motion is almost as good as my other leg. I'm feeling like I will ride again for sure. Question is how long of a distance and how often without feeling pain. Time will tell. The sugeon was a dr. Camuso and he is highly regarded in trauma orthopedic surgery around here. He said the cartilage looked ok but there must be some damage to it. How much and what it means will have to see over time. I just can't wait to build up my leg muscle again and get off these damn crutches!

  23. #23
    Senior Member CHAS's Avatar
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    Quote Originally Posted by BlazingPedals View Post
    Bike falls aren't so intimidating when you're only sitting a foot off the ground. Lowracers or tadpole trikes fit the bill.
    +1
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    Homophobia is so gay.

  24. #24
    GLA
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    Yes, still remember the pain, still remember the frustration.

    The mental part was probably the toughest. My accident happened mountain bike riding and I never really went back to that (only very casual riding). I moved across to road riding and although it took a bit of time to get my confidence back on big downhills, I now ride whatever distances I want to. Just finished Paris Brest Paris 1200km.

    I found setting myself a series of increasing goals helped working through the mental issues.

    All the best.
    "When the spirits are low, when the day appears dark, when work becomes monotonous, when hope hardly seems worth having, just mount a bicycle and go out for a spin down the road, without thought on anything but the ride you are taking."
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  25. #25
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    Adam, sorry you had to go through this! You do get better. They wouldn't let me on the bike for about 4 months. At first, I had to lay the bike on the ground, step over it and then pick it up. The first ride was scary, worrying about another crash and all, but really made me grateful! The hardest thing has been regaining the flexibility, but I was 60 when it happened, so you might have better luck.

    It was a little more than a year before I could actually swing my right (uninjured side) leg over the bike to get on and off it. But I'm riding as well as ever now, pretty much at the same distances and speeds as pre-injury. I don't like riding in big groups because I don't trust them and don't want to crash again, but other than that, I'm fine.

    At my 1 year check up, I had a small spot of AVN on the femoral head. It may or may not progress; I go back in December or January, which will be my 2 year followup. I also developed sciatica issues on my uninjured side during my rehab and that has been more of a problem than the injured area. That seems to be getting better and fortunately doesn't both my riding at all. I do have some low back pain that everyone thinks was caused by the rehab and strength imbalances, but it could also be a pre-exisiting disk problem that was aggravated by the whole episode.

    All in all, I'm doing great and it hasn't been 2 years yet. The dvt set me back a good bit and then the sciatica, but it's mostly all good. I had no problem riding BRAG last summer and I pronounce myself cured from the acetabular fracture. You'll get there.

    Email me if you want to know any more about my rehab experience and what you might expect.

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