Treating a Femur Fracture

How a Broken Thigh Bone Is Diagnosed and Treated

Photo of a man holding a painful thigh.
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The femur, also known as the thigh bone, is one of the largest and strongest bones in the body extending from the hip joint all the way down to the knee joint. Because it is so strong, it requires a significant force to break it.

With that being said, certain medical conditions can weaken the bone and make it more vulnerable to fracture. These include osteoporosis, tumors, infection, and even certain bisphosphonate medications used to treat osteoporosis. Breaks of these sorts are referred to as pathologic femur fractures.

Femur fractures are generally separated into three broad categories:

Proximal Femur Fractures

Proximal femur fractures, or hip fractures, involve the uppermost portion of the thigh bone just adjacent to the hip joint. These fractures are further subdivided into different types:

  • Femoral neck fractures are those that occur when the ball of the ball-and-socket joint is broken at the top of the femur.
  • Intertrochanteric hip fractures occur just below the femoral neck and are more easily repaired than femoral neck fractures.
  • Pelvic insufficiency fractures occur in the pelvic bone rather than the femur itself and can often be treated without surgery.

Femoral Shaft Fractures

A femoral shaft fracture is a severe injury that usually occurs as a result of a high-speed car collision or a fall from a great height.

The treatment almost always requires surgery. The most common procedure involves the insertion of a metal pole (known as an intramedullary rod) into the center of the thigh bone. This helps reconnect the two ends which are then secured with screws above and below the fracture. The intramedullary rod generally remains in the bone but can be removed if it causes pain or other problems.

A less common technique involves the use of plates and screws to secure the fracture which is then held in place by an external fixator. The fixator, which is situated outside of the leg but penetrates the skin to stabilize the bone segments, ensures that the femur is fully immobilized and better able to heal.

Supracondylar Femur Fractures

A supracondylar femur fracture is an unusual injury that occurs just above the knee joint. These fractures often involve the cartilage surface of the knee joint and are most commonly seen in people with severe osteoporosis or those who have previously undergone total knee replacement surgery.

A supracondylar femur fracture is a problematic condition as it can increase the risk of developing knee arthritis later in life.

The treatment of a supracondylar femur fracture is highly variable and may involve a cast or brace, an external fixator, an intramedullary rod, or the use of plates and screws.

Treatment

A femur fracture is always considered a medical emergency requiring immediate evaluation and treatment in a hospital. The treatment is largely dependent on the location of the fracture and the pattern and extent of the break.

Equally as important is the health status of the individual, including the strength and density of the affected bone. Computed tomography (CT) and magnetic resonance imaging (MRI) scans are two standard methods of assessing this.

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Article Sources
  • Von Keudell, A.; Shoji, K.; Nasr, M. et al. "Treatment Options for Distal Femur Fractures." J Ortho Trauma. 2016; 30:S25-27. DOI: 10.1097/BOT.0000000000000621.