Femoral Fractures

A femoral fracture refers to a break or crack in the femur, the largest and strongest bone in the body, located in the thigh. This type of fracture is typically caused by high-energy trauma, such as car accidents, falls from heights, or sports injuries. Due to the femur’s size and strength, it usually takes a significant amount of force to break it, though in elderly individuals with osteoporosis, fractures can occur with less severe trauma, such as a simple fall.

Types of Femoral Fractures

Femoral Shaft Fractures

These occur along the length of the femur and can be transverse, oblique, spiral, or comminuted (where the bone is shattered into multiple pieces).

Proximal Femur (Hip) Fractures

These include fractures near the hip joint and are often referred to as hip fractures. They are more common in older adults.
- Intracapsular Fractures: Occur within the capsule of the hip joint.
- Extracapsular Fractures: Occur outside the capsule, including intertrochanteric and subtrochanteric fractures.

Distal Femur Fractures

These occur near the knee joint and can involve the articular surface of the knee.

Symptoms

– Severe pain in the thigh or hip
– Inability to bear weight on the affected leg

– Swelling, bruising, and deformity in the thigh
– Shortening or abnormal rotation of the leg

Diagnosis

A femoral fracture is typically diagnosed through physical examination and imaging studies, including X-rays.

In some cases, CT scans or MRIs may be used for more detailed imaging, especially if the fracture extends into the joint.

Treatment

Treatment depends on the type, location, and severity of the fracture. Options include:
1. Nonsurgical Treatment: This is rare for femoral fractures, as most require surgery. However, in some cases, traction or a cast may be used, particularly for minor fractures or in patients for whom surgery is too risky.

2. Surgical Treatment:
– Intramedullary Nailing: A metal rod is inserted into the marrow canal of the femur to stabilize the fracture.
– Plates and Screws: Used to hold the bone fragments in place, especially in fractures near the joint.
– External Fixation: A metal frame is used outside the body to stabilize the bone fragments. This is typically a temporary solution.

Rehabilitation

Recovery from a femoral fracture can be lengthy and requires physical therapy to regain strength and mobility.

The extent of rehabilitation depends on the fracture’s severity, the treatment method, and the patient’s overall health.

Complications

– Delayed Union or Nonunion: The bone may take longer to heal or fail to heal.
– Infection: Especially in cases of open fractures or surgery.

– Deep Vein Thrombosis (DVT): Due to immobilization and reduced movement after injury or surgery.
– Fat Embolism: Fat particles may enter the bloodstream and cause complications.

Femoral fractures are serious injuries that require prompt medical attention to ensure proper healing and to minimize complications.

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