Diving while recovering from a hip fracture.

[CWK]

I suffered an impacted fracture of the left femorsl neck on 9 September when I jumped off a dive boat onto Sipadan. I thought that I had a sprain and subsequently did a last dive that involved seimming against a slight current.

As I thought that I had a sprain, I limped around until 15 September when an x-ray revealed the fracture and I have been on crutches since.

The injury has healed quickly, presumably because it was not a serious fracture. Although I am still using crutches, I am now also able to limp without crutches and I would describe the pain associated with the hip to be a minor ache. The last x-ray on 13 October shows that the bone has healed.

I'd like to know if there is any increased risk of DCS if I dived now before the injury to the soft tissues is fully healed? I presume that the tissue compartments for calculating nitrogen on gassing and off gassing is unchanged and that there is no additional risk of DCS.

 

[Duke Dive Medicine]

CWK,

You mention a femoral fracture; was there a soft tissue injury as well? You may be at a theoretically higher risk of aseptic osteonecrosis in the area if you dive aggressively, but that's pretty unlikely in normal recreational diving. Of more concern is the ability of the bone to bear weight. Has your physician cleared you to dive and/or perform full physical activity?

What concerns me most is the fact that there was a fracture in the first place. Femurs are hard to break. Exactly how high did you jump from, and how did you land? How old are you, and do you have any other medical conditions that might make you more prone to injury?

Best regards,
DDM

 

[CWK]

I have no other medical condition but used to smoke (which I'm told may weaken bone). I'm 59 years old and I jumped from a height of about 4 and a half feet (actually about 8 jumps spread over 3 days). On the last jump, I landed on my left foot on oneven wet sand and fell. That's when the injury occurred.

My physician is aware that I will be walking as soon as possible - probably within days rather than weeks and did not appear to have any concerns when I saw him on 13 October, which is when the latest x-ray was taken showing that the bone had healed. I have also used the cross trainer as part of my physiotherapy.

 

[DavidFL]

DDM raises an interesting point. I broke my hip after a fall mountain biking in Oregon, and had the hip repaired by a very competent orthopedic surgeon. When I got home to Florida, my regular GP made the same observations about femurs being large strong bones and asked the same questions...how far was the fall; how hard was the impact? The orthopedic surgeon accepted as a given, probably because of his daily experience in the mountains, that a fall mountain biking is a very plausible way to break a hip. The GP didn't after asking detailed questions. Bottom line result was that I had my bone density tested and was diagnosed with osteoporosis. Turns out it's not an uncommon condition among long distance cyclists. After two years on a daily liquid injection, I now have the less severe diagnosis of osteopenia.

 

[CWK]

I am aware if bone density scans and that is in my immediate future. There is bone degeneration as one ages, I would not be surprised if I had some form of this.

 

[Duke Dive Medicine]

CWK,

Getting back to your original question, I don't think you should dive until you are fully recovered. From your description, that is not the case right now, especially if your physician is considering bone density scans.

Best regards,
DDM

 

[CWK]

DDM,

Apologies for the late response. Did not have wifi for a while as I'm diving on a LOB.

It is not my physician who wants the bine density scan done. I am electing to have one dine.

Have been diving for almost a week without any problems.

Best,

CWK