Femur fractures can happen when a great force is put on the side of the upper leg or when the foot is pushed on, extending the force upward to the femur. This kind of force happens with a fall from a great height or an automobile injury. Fractures of the femur can happen near the ball at the top of the joint and are called “hip fractures”. A true femur fracture happens in the shaft of the femur. Such fractures operate under the force of a great deal of muscle strength so they almost always displace and shorten.
The femur bone is the biggest and strongest bone in the body and it has a decent blood supply. This means that there needs to be a great force to break the bone and there is often a lot of bleeding when the bone breaks. Open fractures of the femur are possible, which can lead to even more bleeding and infection in and around the bone. Because major nerves travel in that area, there can be disruption of nerves in the leg, which may result in permanent nerve damage.
There are three major types of femur shaft fractures. The most common is type I, which is a spiral or transverse fracture. This is the most common type of femur fracture. Type II fractures are comminuted, meaning that there is more than one fragment. In a type III fracture, the fracture is open and infection is likely without intervention.
Doctors have done better in recent years in treating these types of fractures. Fractures are immobilized better so that there can be fewer complications and better healing. While still at the accident site, the femur is splinted in the position in which it was found unless there are signs of neurovascular compromise. Traction is used to pull the fragments apart and align them in their anatomic position.
Morbidity and mortality are reduced if the traction can be maintained and the patient can be ambulated in order to avoid the risk of blood clots and other risks of being in bed for long periods of time. Surgery which includes inserting a rod in both ends of the fracture can be done in order to make sure that the bones stay together while healing.
Open fractures are treated with irrigation to remove contaminating agents and then closing the wound, using antibiotics when necessary to keep infection from taking over.
The prognosis of femur fractures depends on whether or not it is comminuted and whether or not it is an open fracture. If infection and nerve damage are avoided, the patient will eventually ambulate within six months of the injury without any splint or other device. The bone will continue to be painful for several years, perhaps indefinitely.
In one study of severely injured motor vehicle accidents, 15 percent sustained femur fractures. These were people who had a higher injury score than those who didn’t have a femur fracture, meaning they had multiple other severe injuries. Bowel and chest injuries were more common in those who sustained femur fractures. Pelvic and upper/lower extremity fractures were more common. This means that having a femur fracture in a motor vehicle accident should be a sign that significant other injuries are involved.