• 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 Fracture
    Femur Fracture
    Copyright © Nucleus Medical Media, Inc.

    Causes

    A femoral fracture is usually caused by direct trauma to the 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

    Older adults are at increased risk of femoral fracture.
    Factors that may increase the risk of femoral fracture include:
    • 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. A dull ache rather than severe pain may be felt when applying weight to the leg. Sometimes pain may be felt in another part of the leg, such as the knee.

    Diagnosis

    You will be asked 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 the femur. Treatment will depend on how serious the fracture is, but may include:

    Initial Care

    Extra support may be needed to protect, support, and keep the femur bone in line while it heals. Supportive steps may include a splint. A walker or crutches may be needed to keep weight off the leg. Casts are rarely used except in young children.
    Some fractures cause pieces of bone to separate. The doctor will need to put these pieces back into their proper place. This may be done:
    • Without surgery—anesthesia will 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, a specialist may be needed. 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 pain medication may be advised to relieve discomfort.

    Rest and Recovery

    Healing time varies by age and 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.
    Activities will need to be adjusted while the femur heals, but complete rest is rarely required. Ice and elevating the leg at rest may also be advised to help with discomfort and swelling.
    Physical therapy or rehabilitation therapy will be used to improve range of motion and strengthen the leg.

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

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

    CANADIAN RESOURCES

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

    When it Hurts to Move—Canadian Orthopaedic Foundation http://whenithurtstomove.org

    References

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

    Femoral shaft fracture—emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T910561/Femoral-shaft-fracture-emergency-management. Accessed August 30, 2017.

    Femur shaft fractures (broken thighbone). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00521. Updated August 2011. Accessed August 30, 2017.

    Femoral stress fracture. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115016/Femoral-stress-fracture. Updated March 20, 2017. Accessed August 30, 2017.

    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 November 2014. Accessed August 30, 2017.

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