Secretary of State John Kerry broke his femur on Sunday when the bicycle he was riding struck a curb near Scionzier, France.
Kerry, a life-long pusher of physical boundaries who has partaken in everything from stunt-flying to windsurfing, is no stranger to sports injuries, as these brutal-looking shiners and broken nose from an ice hockey game in 2012 remind us.
Kerry attributed his 2009 hip surgery and 2005 knee surgery to the toll of hockey and other athletics. Before he entered Congress, he had jaw surgery for a bad bite exacerbated by a run-in with a goalpost.
Before you question why, at 71, Kerry is still strapping on his spandex and helmet and hitting the pavement on his American-built Serotta with a titanium frame, consider this: Physical activity actually helps to reduce older adults’ risk of falls, according to the National Institutes of Health.
“Without the physical activity that comes with doing daily tasks or exercise, your muscles and bones can weaken over time,” the NIH states. “As a result, you could become more — not less — likely to fall.”
The risk of falling — which occurs to more than one in three people 65 or older — increases as we age, according to the NIH. When falls do lead to fractures, they often occur in an older person’s hip, pelvis, spine, arm, hand or ankle.
About 90 percent of hip fractures happen to people over 60, according to the University of Chicago Medical Center. With about 300,000 occurrences each year, the United States has the highest number of hip fractures in the world.
Specific details of Kerry’s latest injury and bone health remain unknown, but we do know that he fractured his right femur — the longest and strongest bone in the body, according to the American Academy of Orthopedic Surgeons. The break occurred near the site of prior hip replacement surgery. No one else was involved in the accident.
Because of the bone’s strength, femur fractures — particularly among young people — often result from a “high energy collision,” such as a car wreck, the AAOS notes. Local officials told the French news service Agence France-Presse that Kerry was traveling at a slow speed, on flat ground.
“The most common cause of femoral shaft fracture is a motor vehicle or motorcycle crash,” the AAOS states. “Being hit by a car as a pedestrian is another common cause, as are falls from heights and gunshot wounds. A lower-force incident, such as a fall from standing, may cause a femoral shaft fracture in an older person who has weaker bones.”
During an appearance on CNN on Sunday, Sanjay Gupta, the network’s chief medical correspondent, said that the fact that Kerry remained conscious after his accident was a promising detail.
“That speaks to the fact that the bleeding probably wasn’t as significant to the upper leg,” Gupta said. “While he may have been in a lot of pain, and probably was in a lot of pain — these hurt a lot — it wasn’t enough, obviously, to render him unconscious.”
Also notable, Gupta added, is the fact that doctors allowed Kerry to fly back to Boston, where, the State Department has confirmed, he is scheduled to see a doctor who previously operated on his hip at Massachusetts General Hospital.
“It’s a long plane trip, and you’d want to certainly make sure someone was stable enough for that flight ahead of time,” he told CNN. “You can just sort of presume that if it was something much more urgent or emergent, they probably would have done the operation there where he was.”
Depending on the nature of the fracture, it can take as long as six months or more for a femur to heal, according to the AAOS. Once a person is able to walk again, they often require crutches or a walker for support.
Because Kerry fractured his leg on the same side where he also had a hip replacement, recovering might be a little tricky, according to Dr. Michael Kessler, an orthopedic surgeon and professor at Georgetown University’s School of Medicine.
If the fracture was closer to the hip, it might have loosened the hip replacement or hindered it’s stability. That might call for a more involved surgical procedure that could prolong the recovery process and require Kerry spend some time using crutches or a walker.
However, the prospects are little better if the fracture was closer to the knee, which would call for less invasive surgery and could lead to Kerry walking out of the hospital in two or three days.
“He’s a healthy, active person, and in the world of replacing joints, 71 isn’t that old,” Kessler said.
(Robert Samuels contributed to this story)
MORE READING: John Kerry cuts short week-long trip after bicycling accident
John Kerry: So far, Iran has lived up to its end of nuclear deal
