Femur Fracture

ExitCare ImageA femur fracture is a complete or incomplete break in the thighbone (femur). This is a serious injury, but is uncommon in sports. Usually the ankle, lower leg, or knee will become injured before the thighbone does.

SYMPTOMS

  • Severe pain in the thigh, at the time of injury.

  • Tenderness and inflammation in the thigh.

  • Bleeding and bruising in the thigh.

  • Inability to bear weight on the injured leg.

  • Visible deformity, if the fracture is complete and bone fragments separate enough to distort the leg shape.

  • Numbness and coldness in the leg and foot, beyond the fracture site, if blood supply is impaired.

CAUSES

  • A fracture results when the force applied to a bone is greater that the bone can withstand. Thighbone fractures often result from a direct hit (trauma).

  • Indirect stress, caused by twisting or violent muscle contraction.

RISK INCREASES WITH:

  • Contact sports (i.e. football, soccer, hockey), motor sports, and track and field events.

  • Previous or current bone problems (i.e. osteoporosis, tumors).

  • Metabolism disorders or hormone problems.

  • Nutrition deficiency or disorder (i.e. anorexia and bulimia).

  • Poor strength and flexibility.

PREVENTION

  • Warm up and stretch properly before activity.

  • Maintain physical fitness:

  • Muscle strength.

  • Endurance and flexibility.

  • Cardiovascular fitness.

  • Wear proper protective equipment (i.e. thigh pads for football or hockey).

PROGNOSIS

This condition can often be cured with proper treatment, though it may take 6 to 8 weeks to heal.

RELATED COMPLICATIONS

  • Low blood volume (hypovolemic) shock, due to blood loss in the thigh.

  • Failure of bone to heal (nonunion).

  • Bone heals in a poor position (malunion).

  • Increased pressure inside the leg(compartment syndrome), due to injury that disrupts blood supply to the leg and foot and injures the nerves and muscles of the leg and foot (uncommon).

  • Shortening of the injured bones.

  • Increased chance of repeated leg injury.

  • Stiff hip or knee.

  • Hindrance of normal bone growth in children.

  • Risks of surgery: infection, bleeding, injury to nerves (numbness, weakness, paralysis), need for further surgery.

  • Infection of open fractures (skin broken over fracture site).

  • Bone forming within the muscle (myositis ossificans).

  • Longer healing time, if activity is resumed too soon.

TREATMENT

Treatment first involves the use of ice and medicine to reduce pain and inflammation. Treatment of thighbone fractures often requires surgery, to allow the bone to heal in proper alignment, and to reduce the risk of possible complications. Surgery often involves placing a metal rod down the center of the bone, or fixing plates and screws over the fracture line. Use of a cast is not common, because the cast would need to involve the stomach, low back, pelvis, and extend to the foot. For adults, traction (applying pressure using a device) is not often advised, due to the need for prolonged bed rest (6 to 8 weeks). In certain cases, bone growth stimulators may be advised. After the bone heals (with or without surgery), stretching and strengthening exercise is needed. Exercises may be done at home or with a therapist. The rod, plate, and screws from surgery are only removed if they cause further discomfort.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Stronger pain relievers may be prescribed by your caregiver. Use only as directed and only as much as you need.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks, despite treatment.

  • The following occur after restraint or surgery. ( Report any of these signs immediately ):

  • Swelling above or below the fracture site.

  • Severe, persistent pain.

  • Blue or gray skin below the fracture site, especially under the toenails. Numbness or loss of feeling below the fracture site.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)