Femoral Shaft Fractures
The femur or thigh bone is the long bone in your upper leg. Fracture to this bone requires a lot of force as it is the strongest bone in the body with good muscular support, and usually occurs due to high-energy accidents, falls from a height or gunshot wounds.
These fractures are usually associated with severe pain, tenderness, swelling, deformity, inability to bear weight and shortening of the limb.
Femoral fractures are classified based on the location along the length of the bone (closer to the hip, middle or knee), pattern or direction of break (cross-wise, middle or lengthwise) and if the skin is intact (closed fracture) or broken by the fractured bone (open fracture).
When you present with a thigh fracture, your doctor will review your medical history and perform a thorough physical examination. X-rays are ordered to visualize the fracture site and determine its nature. CT scans may be ordered for a clearer picture of the injury.
Femoral shaft fractures are usually treated by surgery. If the fracture site is exposed, the wound is cleaned to prevent infection and surgery is initiated immediately. If the skin is intact, your doctor will wait until swelling subsides and you are stable. During this time, your leg is placed in a splint or skeletal traction for support. Surgery may involve one of the following:
- External fixator, which involves inserting pins into the bone above and below the fracture site and connecting them to an external rod. This device is left until the bone heals in the right alignment.
- Intramedullary nailing, where a small incision is made in your hip or knee and a rod inserted into the central cavity of the femur, extending along its length, and is screwed at its ends holding the fracture fragments in their correct position for healing.
- Plates and screws are used to stabilize the fracture if the fracture extends into the hip or knee joints.
Femoral shaft fractures usually take 4-6 months to heal. Your doctor will encourage you to move the leg in the early phase of recovery, but not to bear weight. You must use a walker or crutches initially and gradually bear weight once the fracture has sufficiently healed. Physical therapy is recommended to improve strength and range of motion lost because of the injury and immobilization.