Secretary of State John F. Kerry flew home to Boston on Monday night, where he will undergo surgery on Tuesday morning at Massachusetts General Hospital to repair a fracture to his right leg sustained during a cycling accident in France.
Kerry, who arrived at about 9 p.m. at Logan Airport, traveled with a small entourage that included Dr. Dennis Burke, the Mass. General orthopedic surgeon who in 2009 replaced one of Kerry’s hips, and in 2010 the other. Burke flew to Geneva late Sunday so that he could accompany Kerry back to Boston.
Burke is expected to perform surgery Tuesday morning to set the broken leg, according to a State Department spokesman. Kerry will undergo the procedure after participating, via telephone, in a meeting on the Islamic State taking place in Paris.
Kerry had been scheduled to attend the meeting before his injury forced him to cancel.
“I think it’s premature quite frankly to speculate on what his recovery will look like,” State Department spokeswoman Marie Harf told reporters during a briefing in Washington. “Let’s let him get back to Boston, get the treatment he needs, and then I think his doctor will provide more information.”
She said Kerry “is committed to an aggressive, ambitious, and responsible recovery timeline.”
While only limited information has been released about the precise location and severity of the femur fracture, concerns have been raised about potential complications because of Kerry’s earlier hip replacement on that same side, and about how the injury might affect Kerry’s high-stakes push for a nuclear deal with Iran. The US-led framework deal was agreed to in early April, but the deadline for the final terms is June 30.
Hip replacements typically involve inserting a metal stem into the femur, also called the thigh bone, which is hollow. The bone then bonds with this stem. Sometimes, subsequent fractures in the area near where the metal stem was inserted can displace the implant, which would require surgeons to replace that stem.
“Implants are like cars — there are lots of different types and models. Some of [the stems] go a third of the way down the femur,” said Dr. Vivek Shah, a surgeon at New England Baptist Hospital who specializes in hip and knee surgery.
If that metal implant was disturbed when Kerry hit a curb and fell off his bike while cycling in the Alps, or if the fracture was in this area of his thigh, he may require insertion of another, longer rod to fix the hip replacement, in addition to plates, screws, and cables to stabilize the new fracture, said surgeons who read about Kerry’s accident but have not examined him.
This worst-case scenario would likely mean a longer recovery period, as long as three months with limited weight bearing, surgeons said.
“If he is lucky enough, and it’s a femur fracture that does not involve his hip or knee, he could get it fixed with plates and screws,” said Dr. Douglas Ayres, chief of joint replacement at Beth Israel Deaconess Medical Center.
In that case, recovery could be as short as six to eight weeks.
But what about air travel for Kerry, who has kept up a dizzying pace of globe-trotting over the past two years, and is staring at the June 30 Iran-deal deadline?
“He is healthy, and a young 71. This guy was bicycling. As long as he didn’t have a terrible injury it’s possible,” he may be able to fly by the end of the month, said Dr. Michael Parks, a surgeon specializing in joint replacement at Hospital for Special Surgery in New York, and a spokesman for the American Academy of Orthopaedic Surgeons.
Kerry never lost consciousness during his accident, and a State Department official said he sustained no other injuries aside from road rash on his arm.
Before leaving Geneva, Kerry posted a message on Twitter saying he was grateful for the French and Swiss police and medical teams. “Headed back to Boston,” he posted. “Look fwd to getting leg set & getting back to @StateDept! Meantime, work goes on. Big thanks for well-wishes. #Onward”
Kerry on Monday morning also spoke with his French counterpart, Laurent Fabius.
He “had a good voice,” spoke in French, and vowed to the foreign minister that he would “come back to cycle in France,” according to the French news service Agence France-Presse.
Kerry’s accident cut short a European trip and added another complication to the push for a nuclear deal with Iran. Kerry has been spearheading the final negotiations on a pact that would restrict Iran’s activities in exchange for gradually lifting economic sanctions.
Before his injury, Kerry had been planning to use the next few weeks to try and secure the final deal, a time frame that State Department officials said Monday will not change.
“Secretary Kerry’s main focus for the month of June remains squarely on the Iran negotiations. I want to be very clear about this: His injury does not change that,” said Harf, the State Department spokeswoman. “The secretary is absolutely committed to moving forward with the negotiations, proceeding with them on the exact same timetable as before his accident.”
She said he still planned to be personally engaged, and in the room for negotiations. The negotiations have been scheduled to take place in a European capital, and Harf declined to say whether that might change.