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.

Interesting thread since I’m going in tomorrow for nail and screw removal from my right femur (hip). I’ve had it in for a year now (November). Check in tomorrow. Surgery on Monday. .

A bit worried about the temporary hollow bones but doc says I only need be careful for a couple months, e,g., no running or strenuous activities.

I’m really curious how long before bone will be ready/recovered to handle running.

Good afternoon,

I had an intertrochanteric fracture that was fixed with a PFN on the 8th of May. At the moment, I can walk without crutches but I still need to build up some more strenght on the injuried leg. I am also considering to remove the hardware at one point but today I had my first follow-up X-Ray and discusson with the orthopedist. She mentioned that the recovery after PFN removal would be much more difficult compared to initial recovery after the fixation surgery.

Therefore, I would like to hear how was yours. I really appreciate the stories above and they give me optimist.

[KickrLin], can you give us a follow-up?

Wishing you all smooth recovery and good health!

I’m no doc but based on my own experience and what I’ve read, the fact that you’re up and about so quick is amazing! Guess it really depends on the doc and nature of the break.

Maybe you misunderstood the bit about PFN removal and recovery. My doc said it would be easy, both the surgery and the recovery compared to the initial surgery to fix me. One, it would be ~1hr vs the 3-4hrs for the first surgery. Two, I’d walk out of the hospital the next day. I’d have to go back 2wks later for removal of staples. Finally, I’d have to be careful for 2-3mo afterwards as the holes in the bones from removed hardware filled back in. No running, strenuous exercise, avoid any knocks to the hip/leg. But, normal walking stuff would be fine.

As for the actual removal, it never happened. I checked in to the hospital for surgery. But on the day of my surgery, my doc got called into an emergency surgery and I was pushed off the schedule. We discussed rescheduling, but I decided to leave it and see if I could live with it. That was Dec 2022. It feels a lot better since then. I think this is mostly due to the fact that I’ve also done a lot of strength and mobility work since January. At this point, unless something strange happens, I’ll probably leave the hardware vs doing 2-3mo of nothing while waiting for bones to fill in.

I’ve tried to keep it short, omitting some details. But if you have more questions, don’t hesitate to ask.

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hi, my friend (29 M) is going to have a femur nail removal soon. He fractured his femur in 2018, being a fitness trainer he is comfortably lifting heavy weights (squatting 120kg), he is worried about the surgery and recovery, how long before he can resume work and what would it mean for his own training. It would be really helpful if he is mentally prepared, so I am looking for as much information as I can get about the surgery itself and recovery. thankyou.

Curious why he is getting it removed 5yrs later? At this point if he is comfortable, why bother?

When I was prepping for removal, my surgeon told me I would walk out the day after surgery assuming no complications. He said I’d have some soreness at the incision sites from the staples, but that’s it. Two weeks later, the staples come out. Then, it would be an about 2 months to let the holes in the femur grow back in (refill). During that time, no running, football, etc… I doubt your buddy doing leg day is going to be advised during this 2mo or so.

That was supposed to happen last Dec. At this point, unless something changes, I see no reason to go back and get it taken out.

he says it’s uncomfortable, he has made up his mind. let’s see what the doctors say. i hope everything
works out for you.

5 years after surgery I was still VERY uncomfortable.

I actually saw a doctor about 5 years after surgery, I had just finished an ironman, but had a cyst near my knee from the screws ( still do ) and could not lay on that side. At times the hardware would “catch” tissue trying to slide over it.

To date I still have a massive left/right imbalance, but most people looking at me would never know I’ve had surgery.

Surgery never did happen, was supposed to be schedules for winter ( work down time ) instead I was thrown on the “wait list” and after I couldn’t go in and do it on a week’s notice 3 times ( I work in construction, can’t just not work on that short of notice, and I take part in sport the rest of the year too ) I was taken off the wait list.

It’s now been 13 years, and it’s only felt better and better over time and I think at this point I’d leave it.

Something to keep in mind, the longer it’s been in there, the more calcified in place it is, the more destructive means they gotta use to remove it.

I’ve seen video and ouuuuch, it looks traumatic lol.

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