Hip Pinning Surgery and a Cobra Fixator

In the first week of this month, my mother-in-law had an unfortunate accident at the market. She's 77 years old, though she's no ordinary old lady.

At her age, she's still spritely in her activities and manages to do most household tasks without any problem. She doesn't seem to tire easily compared to most senior citizens.

I would say she's the healthiest and strongest 77 year-old woman that I've seen.

The above thumbnail with an x-ray image doesn't belong to her, by the way. But that solid white shape on the right shows an implant that is very much similar to what she now has in her right hip and thigh bone.

The implant is an 8-inch titanium piece with a ball (femoral head) on top roughly 4 centimeters in diameter.


The Hip and Wrist Fracture Accident

My mother-in-law went together with my brother-in-law to the market and there was a short time that they were separated. During this time, she miscalculated a step near the sidewalk and she fell on her right side.




She used her right hand to help cushion the fall and it was her right hip which suffered the most impact. This was on a Wednesday.

My wife's siblings got her immediately to Makati Medical Center where they patiently waited for an available room. The orthopedic surgeon, Dr. Leagogo, who examined her confirmed the right hip and right wrist fractures.

After a go-signal from the cardiologist, Dr. Rosas, surgery for both was scheduled on the week's Saturday.


Hip Pinning and Cobra Fix Surgeries

The operation started Saturday morning and lasted almost at noon. This was surgery for both the right hip and right wrist.

A device called Cobra Fixator or Cobra Fix was implanted on to the wrist area. Its purpose is to keep the right hand and wrist bones together and properly aligned.

The Hip Pinning procedure for my mother-in-law (MIL) was a little more complicated. Apparently, the right femur (or thigh bone) was fractured and the femoral head (the ball head on top of the thigh bone) was crushed and had to be replaced.

A titanium replacement had to be implanted with a thigh "bone" that's eight inches long. This titanium piece was inserted into the remaining bone's marrow.

The procedure required only a small incision on the side of the right hip, and the pins and screws will provide a solid connection for the broken bones.

My MIL was able to move right away after surgery - and that's what doctors want - so the patient is more likely to avoid the serious complications that can arise with being immobilized in bed.

Most hip fractures would actually heal without surgery, but the problem is that the patient would be in bed for eight to 12 weeks.




Surgeons have learned over the years that confining an aging adult to bed for this period of time has a far greater risk of creating serious complications than the surgery required to fix a broken hip.

The goal of the hip pinning procedure is to set the bones securely in place, allowing the patient to get out of bed as soon as possible.


Visit to the Hospital

We visited my MIL the day she was operated and that was Saturday. I was hesitant a bit because I wasn't sure if that was the best time to visit. In hindsight, I was right because it took a while before the recovery room discharged her.

We arrived at the hospital at around 2:30 pm. We left at around 5 pm and came back after learning that she was finally brought to her room at around 7 pm.

Here's the gang visiting my MIL (well, more like watching TV), while my MIL rests.


She's actually too groggy to open her eyes. She knew we were there and made feeble attempts to wave to us when we left.





Remarkable Recovery after the Operation

My MIL was already moving her leg the following day. And a couple of days thereafter, she was attempting to walk with the help of the physical therapist at the rehab center.

Her orthopedic-surgeon, Dr. Leagogo, was so amazed that he exclaimed "Wow, is this the same patient I just operated on?" Or maybe, it was just the doctor's way of encouraging her further.

At the rehab center, there were other patients in various stages of therapy or rehabilitation. One was using the stationary bike while another was walking with the aid of the bars.

After seeing these patients do their therapy exercises, my MIL was inspired to be committed with her recovery exercises. She muttered to herself that she'll be doing the same exercises as the others in the next few days.

The physical therapist encouraged my MIL to begin getting up and walking. She can't use a walker though because of her fractured wrist which still has the Cobra Fixator.

Even bending the knees had its limitations. Nonetheless, my MIL dutifully performed the exercises as directed by the head therapist, Dr. Mercado.


Psychological Barrier Towards Recovery

Dr. Leagogo was so visibly impressed with my MIL's recovery that he requested her to visit another patient who was just recently operated. Apparently, the patient became immobile after the surgery because she refused to attempt to walk.

I'm not sure why this particular patient refused to walk though. Was it purely psychological?




Was it fear of getting hurt after taking the first step? But Dr. Leagogo was hoping my MIL could explain her personal experience and help motivate this bed-ridden patient.

That didn't happen though because my MIL was immediately discharged the next Friday. DH and I fetched her from Makati Medical Center to bring her home. Thanks to her Philhealth membership and Senior Citizen benefits, the total bill was reduced significantly.


Physical Therapy Sessions after the Surgery

Presently, my MIL still has problems walking. She is undergoing physical therapy at Makati Medical Center as an outpatient. The physical therapist is unable to provide home services partly because the therapy sessions require some equipment like the stationary bike.

The therapy sessions are done three times a week with each session lasting around two hours. Each succeeding session become increasingly challenging compared to the previous and so far, MIL is quite pleased with the results.

It will take a few months, maybe, before my MIL will have full control of the motor skills on her wrist and her leg, but I'm quite sure her positive attitude would prove to be an important factor towards that full recovery.



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