From the archive · By David Abbasi, MD · March 8, 2022

Tony Hawk's Femur Fracture, Explained

Tony Hawk shared an X-ray and an account of a serious leg injury on Instagram, and Dr. David Abbasi commented on what the images appear to show. What follows is a general explanation of the injury and the operations used to treat it, based only on those public images. It is not a diagnosis, and Mr. Hawk is not a patient of this practice.

The Injury

The images appear to show a fracture of the femur. The femur is the thigh bone, and it is among the strongest bones in the body, so a break of this kind usually follows a high-energy impact rather than an ordinary fall.

Intramedullary Nailing

The X-ray shows an intramedullary nail. A metal rod is passed down the hollow center of the femur and locked at each end, so that the bone is held from the inside while it heals. The technique suits complex fractures of the long bones, because the rod shares the load along the length of the bone rather than at a single point.

The Screws Across the Hip

Three screws appear across the hip. Screws in that position are used for a fracture of the femoral neck, the short segment between the shaft of the femur and the ball of the hip joint. Fractures there are often less displaced, which means the bone has cracked without shifting far out of position, and screws hold the fragments in alignment while they unite. Whether that is what happened here cannot be established from a photograph.

Retrograde Nailing & Weight-Bearing

The nail appears to have been placed retrograde, entering at the knee and passing upward toward the hip. Photographs taken since the operation appear to show weight going through the leg. Where a femoral neck fracture is also present, weight-bearing is usually staged carefully, because loading the hip too early risks the position of the repair.

What Follow-Up Imaging Shows

Recovery from an injury of this kind is judged on follow-up X-rays rather than on how the leg feels. Those images show whether the fracture is uniting and whether the implants are holding their position, and they are what a surgeon uses to decide when activity can be increased.

Why This Matters Beyond One Athlete

Femur fractures are among the injuries where the operation is only the first part of the treatment. The rehabilitation that follows, and the staging of weight through the leg, do as much to determine the result as the metalwork does.

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John Incampo3 weeks ago

I always get very nervous when i go to drs but dr Abbasi put me at ease He is very easy to speak with and has great way of communicating So if u want a dr who is cool and knows his stuff he is the man to see. I also want say his staff is very professional and friendly. And when people are nice like they all are it makes things so much easier especially when your a nervous nelly