Femur Fracture

A femur fracture is a break, a crack, or crush injury of the thigh (femur) bone. A femur is the longest and the strongest bone in the human body. The long, straight part of the femur is called the femoral shaft. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture.


Femur fractures vary greatly, depending on the force that causes the break. Femur fracture is classified into three types, depending on the location of the fracture:

  • The location of the fracture (the femoral shaft is divided into: distal, middle, proximal)
  • The pattern of the fracture (bone-break cross-wise, length-wise, or in the middle)
  • The tear of the skin and muscle above the bone by the injury

Common types of femoral shaft fractures are:

  • Transverse fracture : The break is a straight horizontal line going across the femoral shaft.
  • Oblique fracture: This fracture is angled line across the shaft.
  • Spiral fracture: The fracture line encircles the shaft.

Comminuted fracture: This fracture has the bone broken into three or more pieces.

Open fracture: In this fracture, the bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open or compound fracture. Open fractures involves more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications, and take a longer time to heal.

  • High-energy collision in young persons
  • Motor vehicle or motorcycle crash.
  • Being hit by a car
  • Falls from heights and gunshot wounds.
  • A fall from standing, in an older person with weaker bones.
  • Immediate, severe pain.
  • Unable to put weight on the injured leg,
  • May look deformed — shorter than the other leg and not straight.
Physical examination for:

  • Deformity of the thigh/leg (an unusual angle, twisting, or shortening of the leg)
  • Skin breaks
  • Bruises
  • Pieces of bone pushing on the skin

Imaging tests:

  • X-rays: to determine the type of fracture and location in the femur.
  • Computed tomography (CT) scan: To get more information about the fracture or see the lines, not visible from x-rays.
  1. Non-Surgical

    Most femoral shaft fractures require surgery to heal, except in young children where a cast is used.

  2. Surgical Treatment:

    The timing of the procedure is planned depending on the intensity and complexity of the fracture. In case of open fractures, surgery is done immediately to prevent infection.

    • Long-leg Splint or Skeletal traction: Between initial emergency care and your surgery, your leg may be need either a long-leg splint or in skeletal traction to keep your broken bones as aligned and to maintain the length of your leg.
    • External fixation is usually a temporary treatment for femur fractures in which the metal pins or screws are placed into the bone, above and below the fracture site. This holds the bones in the proper position to help healing. External fixators are often used in a patient who has multiple injuries and not ready yet, for a longer surgery to fix the fracture.
    • Intramedullary Nailing: This is a method in which a specially designed metal rod is inserted into the marrow canal of the femur. The rod passes across the fracture to keep it in position while healing.
    • Plates and Screws: During this operation, the bone fragments are first repositioned into their normal alignment with special screws and metal plates attached to the outer surface of the bone. Plates and screws are often used when intramedullary nailing may not be possible

Most femoral shaft fractures take 4 to 6 months or even longer to completely heal depending on the complexity of the fracture.

  • Pain Management: Medications are often prescribed for short-term pain relief after surgery or an injury.
  • Weight bearing: Doctors recommend leg motion early in the recovery period. Most likely you will need to use crutches or a walker for support.
  • Physical Therapy: Physical therapy is essential to restore normal muscle strength, joint motion, and flexibility.

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