Anyone had an Intramedullary Nail removed? Your experience in recovery time

I’m purely looking for anecdotal experience here. I’ve talked with my surgeon and have his view on things, and his response is “it depends”.

I’m having a proximal femoral nail removed in two weeks. It was inserted following an off during the bike leg of IM Wales in September of last year resulting in
a neck of femur fracture. Healing and rehab went well for swimming and cycling, but due to my build the hardware has been irritating m ITB (protrusion of the distal pin and top locking screw) and I haven’t been able to hit my stride (sorry!) with running. Despite building to 10 miles distance things are just too uncomfortable around the hip, quad and knee

I’m interested in knowing how long it took you to recover after such a procedure. How long before you were comfortable weight bearing, and how long before you resumed training. While considering surgery to remove the nail I’ve been working on overall strength to build durability and have met Chad’s recommendations for strength standards on all but chins, so I’m hoping this will stand me in good stead.

Of course I will take my lead from my surgeon and PT etc…

Just a follow-up on this. Physical recovery went well, I was mobilising without crutches the next day and the ITB irritation caused by the nail was pretty much resolved instantly. Pain was quite manageable.

I have had a complication, I picked up a post-op infection and ended up hospitalised on IV antibiotics with two further procedures to clean out, drain and re-close the wound. That was an unpleasant (I really was quite ill) and unexpected 5 days in hospital. I’m now home with a further course of antibiotics and strict orders to rest. Hopefully with a solid couple of weeks of rest I’ll be able to get back at it.

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Hi, I was just looking at your post whilst searching out advice on recovering from injury… I too have broken by neck of femur and have an IM nail in situ… Mine is about 5 years old now. I’m predominantly a cyclist but did find it a bit painful on the odd run. Has your pain resolved now you’ve had the IM nail out? Unfortunately I’ve now fractured my spine so having been very fit ready pre Christmas in planning for road racing next year, I face a long road to recovery. Anyway, just thought I’d say hi… hope you’ve made a good recovery from your latest surgery and are ready for triathlon in 2020! best wishes, Martin.

Hi Martin,

Indeed the pain did settle down after having the nail removed. I would say it took two months for the bursistis to settle. Unfortunately I had a fall on some ice in November and landed right on my weaker hip (still a void in the neck where the nail had been) causing another fracture. This time it was at the narrowest part of the neck, it was fixated using 3 cannulated screws. I was completely non weight-bearing for 6 weeks but now it seems to have healed pretty well. I do have another complication, one of the screws is actually poking through the end of the femur into the hip joint and is aggravating cartilage. That screw is being removed next week. Hopefully it will be a quick recovery and will be back at it by February.

Sorry to hear about your spine, heal well! Injury sucks…

Nightmare! sorry to hear about your misfortune… sounds like you’ve had a really tough time. All the best for the recovery and take care once you’re back out there.

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Just checking in here.

I had the screw removed but that damn infection reared it’s head again. I avoided surgery this time, it was dealt with by IV antibiotics initially and now I’m on hopefully the last week of oral Flucloxacillin. Still a bit of discomfort but I’m starting to work on getting the strength back. Finding Whitney is a good workout, hoping Tabatha sessions will help with muscular recruitment.

Hi @pgyates1983,

Thanks for your testimony! Your second breaks has been 4 months after the nail removal, is it exact ? The bone was not consolidated yet or the fracture would have happen anyway because your fall was big ?
I am planning it too and my doctor told me I should be careful for the 6 weeks…but 4months is a different story especially because I like moutain biking and skiing so it means I would need to wait way longer

Hi, this is a really interesting thread.

I had 5 open fractures in my Tibia and Fibula, and 2inches by half inch from the side wall of the tibia was also broken off, this happened in August 2018, the final operation resulted in an “IM Nail” from my kneecap to my ankle, all of the breaks were fully fused only in early 2021 but won’t have full integrity (where the bone has finished rebuilding and strengthening the internal structures of the bone) till 2024, 2025. (Just like to note that the injuries ranges were from my ankle to my upper shin)

I suffered multiple Staphylococcus Aureus infection in a cyclical date structure, but touch wood the the last 2 cycles I haven’t had any infection however I have changed what I put in my body in terms of food and drink in an extremely dramatic way.

Without giving all the details in between about six months ago I had very limited movement in my ankle until I had another accident and fractured my ankle which healed within a week and opened up movement that I never had previously, so I’ve been making really good progress with my health and the rest of my body I.e. fitness, practicing Parkour, nutrition, gut health and just being athletic, i believe iv proved the doctors wrong that said I could never do Parkour, however I’m still majorly held back by my leg and have always had the constant pain that never stopped from day 1 after recovery.

Moving to the punchline, for many reasons here and there I believe that the nail and the 3. Screws that are holding the nail in place are limiting my movement and causing pain, I honestly don’t mind about the pain as long as I know it’s not killing me. I don’t think I can progress my leg any further without having the nail out, my son is 4 now and you can gather on your own the reasons I debate about it with myself, how long will it take to recover?, how much more damage will they do to my leg cutting me open again,? will I lose my ability to fight off the infections that iv only just stopped having, there’s obviously much more but I’d like to know what you guys thing about it. Thanks

Firstly I’m really sorry I missed this… did you go for the removal in the end? My second break was pure bad luck, that side will always be a little weaker but it has been worth it to overcome the discomfort.

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Moving to the punchline, for many reasons here and there I believe that the nail and the 3. Screws that are holding the nail in place are limiting my movement and causing pain, I honestly don’t mind about the pain as long as I know it’s not killing me. I don’t think I can progress my leg any further without having the nail out, my son is 4 now and you can gather on your own the reasons I debate about it with myself, how long will it take to recover?, how much more damage will they do to my leg cutting me open again,? will I lose my ability to fight off the infections that iv only just stopped having, there’s obviously much more but I’d like to know what you guys thing about it. Thanks
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This was my experience, the hardware was casuing discomfrot that I couldn’t quite put my finger on. I also had Heterotopic Ossification that was removed after the second set of hardware was taken out. I encountered a second infection too, but a round of antibiotics tackled it. I have since had ankle surgery to repair a torn ATFL and impingement (possibly aggravated by all of the single leg weight bearing I had due to my hip) and had no further infections. This said, your injury sounds much more complex than mine but I can attest that the protruding hardware caused issues for me around my soft tissues/ligaments etc… a couple of years on I still have residual numbness but my range of motion is excellent. No regrets for me.