For the average patient, I’d say, ‘Don’t plan travel for at least three months,’ ” said David Teuscher, the president of the American Academy of Orthopedic Surgeons. “Now, the average patient is not John Kerry.”He could have a personal physician travel with him or outfit his plane in a way that could keep his leg immobilized. Still, there could be concern over the next few weeks with him leaving on a trans-Atlantic flight so quickly after surgery.“Maybe they need to invite leaders to come to Boston and have them meet in Boston instead of him going elsewhere,” said Teuscher, a surgeon in Beaumont, Texas. Kerry has kept a dizzying pace over the past two years, traveling nearly 820,000 miles and visiting 63 countries. He’s spent 1,780 hours — some 74 days — in the air, and his legacy so far has been defined by an energetic pace his younger aides have trouble maintaining. This is the first time he’s been sidelined for his health.

It is unclear how severe the fracture is and how long it will take for Kerry to recover. It can take four to six months for a broken femur to fully heal, according to the American Academy of Orthopedic Surgeons. The femur, also known as the thighbone, is the longest and strongest bone in the body, and it usually takes significant force to break it.

Although Kerry would be on crutches or in a wheelchair during a signing ceremony with Iran — if there is one — it’s not a situation the man with a lifetime of sports injuries hasn’t confronted before. In 2012, he showed up for a ceremony at the White House with two black eyes and a broken nose, the result of having been struck in the face with a hockey stick. Kerry is a longtime cyclist who frequents Belmont Wheelworks for repairs on his titanium Serotta Ottrott. He uses it for exercise, to clear his head, and, at times, to conduct deals. In 2010, when then-Senator Scott Brown was indecisive on whether to support a financial regulatory overhaul, Kerry took him on a 40-mile bike ride where they came to terms. As secretary of state, he often travels with his bike, and he usually has a stationary bike in his hotel room. He has done the 111-mile Pan Mass Challenge about a dozen times.

Dr. Dennis Burke, an orthopaedic surgeon at Massachusetts General Hospital, said the surgical procedure to repair Kerry's broken femur "was uncomplicated, the fracture was fully repaired, and we plan to get him up walking on Wednesday." He said the surgery was done using a regional anesthetic, and Kerry was conscious throughout the 4-hour operation.
"I anticipate a short hospitalization, a full and complete recovery, and a return to normal function," Burke added. "I do not anticipate that this will interfere with his duties as Secretary of State."