Femur fracture (Thigh bone)

A femoral shaft fracture is a break (fracture) in the shaft of the thigh bone (femur). The femur is the long bone that connects the hip joint to the knee joint. Most femoral shaft fractures are closed fractures. A closed fracture is a break in a bone that happens without any cuts (lacerations) through the skin that is near the fracture site. Some femoral shaft fractures are open fractures. An open fracture is a break in a bone that happens along with lacerations through the skin that is near the fracture site.

What are the causes?

A healthy femur may break from a forceful impact, such as from:

• A fall, especially from a great height.

• A high-impact sports injury.

• A car or motorcycle accident.

A weakened femur may break from minimal impact or force due to:

• Certain medical conditions.

• Age.

What increases the risk?

This condition is more likely to develop in:

• Older people.

• People who have certain medical conditions that cause bones to become weak or thin, such as: a) Osteoporosis. b) Cancer. c) Osteogenesis imperfecta.

• People who take certain medicines (bisphosphonates ) that are used to treat osteoporosis. People who participate in high-risk sports or impact sports.

What are the signs or symptoms?

Symptoms of this condition include:

• Severe pain.

• Inability to walk.

• Bruising.

• Swelling or visible deformity of the leg. Substantial bleeding, if it is an open fracture.

How is this treated?

A femoral shaft fracture usually requires surgery. You may have one or more of the following surgical treatments:

• External fixation. This involves using pins and screws to hold the bones in place if there is extensive soft tissue injury. After some time, you may need an additional surgical treatment, such as intramedullary nailing.

• Intramedullary nailing. This involves inserting a rod (intramedullary nail ) through an incision. The intramedullary nail goes down the center of the shaft of the femur. It may be inserted in the knee joint or from the top of the femur near the hip. Generally, screws are placed through the rod at both ends to prevent shortening or rotation of the femur as it heals.

• Plates to stabilize the fracture. These may be used, especially when the fracture is at either end of the bone, near the hip or the knee.

In rare cases for which surgery is not an option, a cast or a splint may be used to hold (immobilize ) the bone while it heals.