Femoral Fracture

(Femur Fracture; Thigh Bone Fracture; Broken Leg)

Definition

A femoral fracture is a break in the thigh bone, which is called the femur. It runs from the hip to the knee. It is the longest and strongest bone in the body. It usually requires a great deal of force to break the femur.
Femoral Fractures
Femur Fracture
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Causes

A femoral fracture is usually caused by direct trauma to your femur. Trauma may be caused by:
  • Car, motorcycle, or pedestrian collisions
  • Falls
  • Blows
  • Severe twists
  • Gunshot wounds
Femoral fractures may also be caused by low-impact trauma or spontaneous breaks from weakened bones.

Risk Factors

Factors that may increase your risk of femoral fracture include:
  • Advancing age
  • Osteoporosis
  • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles, or post- menopause
  • Certain diseases and conditions that weaken bones, such as tumors or cysts
  • Decreased muscle mass
  • Playing certain sports that may result in:
    • Spiral fractures—associated with collisions or falls from sports such as football or skiing
    • Stress fractures—associated with overuse or repetitive motion from sports such as distance running
  • Violence

Symptoms

Femoral fracture may cause:
  • Immediate and severe pain
  • Swelling and bruising around the area of the break
  • Inability to walk or stand and/or limited range of motion of the knee or hip
  • Deformity of the injured leg, such as shortening or abnormal twisting
Stress fractures occur slowly over time with repetitive motion. You may feel a dull ache rather than severe pain when you apply weight to your leg. Sometimes pain may be felt in your another part of your leg, such as your knee.

Diagnosis

Your doctor will ask about your symptoms, physical activity, and how the injury happened. The injured area will also be examined.
Imaging tests may include:

Treatment

Proper treatment can prevent long-term complications or problems with your femur. Treatment will depend on how serious the fracture is, but may include:

Intial Care

Extra support may be needed to protect, support, and keep your femur bone in line while it heals. Supportive steps may include a splint. A walker or crutches may be needed to help you move around while keeping weight off your leg. Casts rarely used except in young children.
Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:
  • Without surgery—you will have anesthesia to decrease pain while the doctor moves the pieces back into place
  • With surgery—pins, screws, plates, or a rod may be needed to reconnect the pieces and hold them in place
In most cases, surgery is needed to repair a femoral fracture.
Children’s bones are still growing at an area of the bone called the growth plate. If the fracture affected the growth plate, your child may need to see a specialist. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.

Medication

Prescription or over-the-counter medications may be given to help reduce inflammation and pain.
Medications may include acetaminophen or ibuprofen.
Check with your doctor before taking nonsteroidal anti-inflammatory medications, such as ibuprofen or aspirin.
Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Rest and Recovery

Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it takes up to 4-6 months for a fractured femur to heal.
You will need to adjust your activities while your femur heals, but complete rest is rarely required. Ice and elevating the leg at rest may also be recommended to help with discomfort and swelling.
As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.

Prevention

To help reduce your chance of femoral fractures, take these steps:
  • Do not put yourself at risk for trauma to the bone.
  • Always wear a seatbelt when driving or riding in a car.
  • Do weight-bearing and strengthening exercises regularly to build strong bones.
  • Wear proper padding and safety equipment when participating in sports or activities.
To help reduce falling hazards at work and home, take these steps:
  • Clean spills and slippery areas right away
  • Remove tripping hazards such as loose cords, rugs, and clutter
  • Use non-slip mats in the bathtub and shower
  • Install grab bars next to the toilet and in the shower or tub
  • Put in handrails on both sides of stairways
  • Walk only in well-lit rooms, stairs, and halls
  • Keep flashlights on hand in case of a power outage

RESOURCES

American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Cummings-Vaughn LA, Gammack JK. Falls, osteoporosis, and hip fractures. MedClin North Am. 2011 May;95(3):495-506.

Femoral shaft fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated March 12, 2013. Accessed September 12, 2013.

Femur shaft fractures (broken thighbone). American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00521 . Updated August 2011. Accessed September 12, 2013.

Femoral stress fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated November 3, 2012. Accessed September 12, 2013.

What are ways to prevent falls and related fractures? National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Osteoporosis/Fracture/prevent%5Ffalls%5Fff.asp . Updated January 2011. Accessed September 12, 2013.

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