A femur fracture is a crack or complete break in the bone of your thigh. A significant amount of force is required to fracture this large bone. The fracture can be caused by direct or indirect trauma. Direct trauma involves a forceful blow to the thigh. Indirect trauma involves twisting the thigh or a violent muscle contraction.
The upper portion of the femur has three main sections: the head, neck, and greater and lesser trochanters. The head is ball-shaped to fit snugly into the hip joint. The neck is the area between the head and trochanters. Each trochanter is a thick bony outgrowth that projects toward the neck and shaft.
The midsection of the femur is known as the shaft. The femoral shaft is shaped like a long tube. It ranges from below the trochanters to structures at the lower portion of the femur named epicondyles and condyles.
Types of Femur Fractures
With its large size, the femur can fracture in many different areas. Fractures of the head of the femur are commonly associated with hip dislocations. Femoral neck fractures usually result from minor trips or falls. This kind of break is most common in women following menopause, when bones can become more fragile. Trochanteric fractures occur primarily in young and middle-aged people, usually from direct trauma such as a blow.
Along with the many places a femur fracture can occur, there are different kinds of fractures:
- Transverse - fracture line goes across the bone
- Comminuted - bone is broken in many pieces
- Open - bone breaks through the skin
- Mid-thigh pain
- Swelling and bruising at the injury site
- Numbness and coldness below the area of the break
Care for a Femur Fracture
Immediate Care: Rest, ice packs to reduce swelling, compression and elevation of the injured leg. If the fracture is open, place a wet sterile bandage over the area. Stay warm to avoid shock, which can be caused by the loss of blood and body fluids. Immobilize the hip and leg and go to an emergency center as soon as possible.
Medical Treatment (nonoperative): Your doctor will need X-rays to diagnose the fracture. If surgery is not necessary, treatment may include setting the bone, traction, and cast bracing. Setting (realigning) the bone requires hands-on manipulation. Traction involves drawing or pulling on the bone by external equipment. Cast bracing immobilizes the limb for typically one to four weeks while the bone heals.
Medical Treatment (operative): Surgical realignment may be needed to secure the bone fragments together. This is completed with hardware such as nails, pins, screws, rods, or plates.
After surgery, your leg will be immobilized in a rigid hip-to-knee cast for approximately six to eight weeks, depending on the type of break. Crutches or a walker will be needed to walk. Traction is also necessary to restore the leg to its correct length.
Your doctor may give you medications to reduce inflammation, pain, and anxiety. Examples of these are ibuprofen (anti-inflammatory), acetaminophen (for pain), and valium (for anxiety).
Talk with your doctor about your rehabilitation program. This will begin after the bone is set and should include physical therapy, as well as a home program. When your cast is removed, heat may be applied to promote healing and offer pain relief. Other options include heating pads, hot baths, and ointments for muscle pain.
Possible complications include shock from the loss of blood and body fluids, infection, poor healing, joint stiffness, shortening of the leg, deformity, difficulty walking, and re-injury to the bone.
Talk with your doctor about your prognosis. Your outcome depends largely on your health before the injury, your age, the type of fracture, and how closely you follow your exercise and rehabilitation programs. Generally, if you are healthy, you will probably return to your regular daily activities following your recovery. Elderly individuals will probably require a longer recovery period and may not fully regain their pre-injury activity level.