Introduction
The femur, located in the thigh, is the body's strongest bone. Though difficult to fracture, a high-impact event like a vehicle accident or a significant fall can cause a break. The treatment approach depends on where and how the bone is fractured, as well as the patient’s age.
Anatomy
The femur, or thigh bone, has a central shaft and contributes to two major joints. The femoral head connects with the hip, while the lower end forms part of the knee joint.
Causes
High-impact forces, such as those from a high-speed car accident or a fall from a height, can cause femur fractures. Older adults may experience fractures closer to the hip or knee due to osteoporosis, a condition that weakens bones.
Symptoms
A femur fracture typically results in intense pain, swelling, and bruising. The leg may appear shorter or misaligned, and movement may be impossible.
Diagnosis
A femur fracture diagnosis involves a physical examination and X-rays of the injured leg, with possible imaging of the pelvis and knee joints. The doctor will assess nearby nerves and blood vessels to ensure they’re intact.
Treatment
In young children, femur fractures in the shaft may be treated with a spica cast, which immobilizes both the hips and the uninjured leg for effective healing.
Surgery
Most femur fractures require a surgical procedure known as intramedullary fixation. This surgery places a rod (intramedullary nail) within the bone, secured by screws to stabilize it during healing. Once the bone has fully healed, the rod and screws may be removed if necessary.
Other surgical options include plating and external fixation. Plating attaches a metal plate and screws to maintain proper bone alignment. External fixation involves a frame outside the leg with pins to stabilize the bone, often used if severe skin wounds are present.
Recovery
Rehabilitation with physical therapy is typically part of recovery. Exercises are introduced to improve range of motion, flexibility, and strength. Those who undergo intramedullary fixation may be able to bear weight and walk earlier than with other treatments. Recovery time varies based on injury severity, location, nerve or blood vessel involvement, and treatment type, generally taking three to six months.
