A broken hip is a life-changing event. One minute you’re fine, the next you’re facing major surgery. If you’ve had a PFNA Nail (Proximal Femoral Nail Antirotation) surgery, it means your surgeon fixed your hip fracture with a specialized rod and blade designed to get you up and moving again. The surgery itself is a modern marvel. But what happens after you wake up? The surgery is just the first step. Your recovery is a journey, and knowing the roadmap can make all the difference.

The Recovery Timeline After PFNA Surgery

Right After the Fix: The First 24-48 Hours

Let’s be real: you’re going to wake up feeling sore and groggy. That’s normal. Your number one job is to work with your nurses to manage your pain. Don’t try to be a hero; staying ahead of the pain will make everything else easier.

Now, here’s the part that might surprise you. Don’t expect to be lying in bed for days. The modern approach to hip fracture recovery is to get you moving—fast. A physical therapist will likely show up at your bedside the very next day. Their goal will be simple: get you sitting up on the edge of the bed, and maybe even standing with the help of a walker. It might feel like the last thing you want to do, but this early movement is crucial for preventing blood clots, pneumonia, and muscle loss.

The First Few Weeks: The Healing Zone

After a few days in the hospital, you’ll either head home (if you have a lot of support) or to a short-term rehab facility. This is where the real work begins. Your surgeon will give you instructions on your weight-bearing status. This is critical. For many PFNA patients, you’ll be on “toe-touch” or “partial” weight-bearing. This means you can put a little bit of weight on your operated leg, but you’ll be relying heavily on a walker. Follow these instructions perfectly—putting too much weight on the leg too soon can mess up the repair.

Your main goals during this time are:

• Wound Care: Keep your incision clean and dry. Watch for any signs of infection (redness, pus, fever) and call your doctor immediately if you see any.
• Pain Management: Transition from hospital-grade painkillers to over-the-counter options as directed.
• Gentle Movement: Continue the simple exercises your physical therapist taught you. This is all about maintaining motion, not building muscle just yet.

1 to 3 Months: Building Back Your Strength

This is the core of your rehabilitation. You’ll be having regular follow-up appointments with your surgeon, who will take X-rays to see how the bone is healing. As the bone gets stronger, your surgeon will give you the green light to start putting more weight on your leg.

Your physical therapy will ramp up significantly. You’ll graduate from a walker to a cane. The exercises will get more challenging, focusing on rebuilding the atrophied muscles in your thighs and glutes. This is a grind. It takes work and consistency, but every single exercise is a step toward getting your independence back. The goal is to improve your range of motion, your strength, and your balance so you can walk safely and confidently without assistance.

3 Months and Beyond: Returning to Life

By about the three-month mark, most people find the bone is largely healed. You might be walking without a cane, and you’ll start to feel more like your old self. However, “healed” doesn’t mean “100% recovered.” It can take a full year or even longer to regain all your strength and endurance.

This is the phase where you start re-introducing normal activities. You’ll likely be cleared to drive again. You can get back to light recreational activities. The key is to listen to your body and not push too hard, too fast.

Your recovery after PFNA surgery is a marathon, not a sprint. The hardware provides the stability, but your commitment to physical therapy is what turns that stability into function. It takes patience and grit, but by following the plan, you can get back on your feet and back to your life.
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