Treating a Femur Fracture

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. Pathological fracture of the femur is a debilitating complication in patients with advanced stage of malignancy.

Types of femur fractures
Illustration by Cindy Chung, Verywell

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 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. External fixation is usually a temporary treatment for patients who have multiple injuries and cannot have a longer surgery to fix the fracture.

Supracondylar Femur Fractures

A supracondylar femur fracture, also called a distal femur, 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

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  1. Choy WS, Kim KJ, Lee SK, et al. Surgical treatment of pathological fractures occurring at the proximal femur. Yonsei Med J. 2015;56(2):460-5. doi:10.3349/ymj.2015.56.2.460

  2. American Academy of Orthopaedic Surgeons. OrthoInfo. Hip Fractures.

  3. American Academy of Orthopaedic Surgeons. OrthoInfo. Femur Shaft Fractures (Broken Thighbone). Reviewed May 2018.

  4. American Academy of Orthopaedic Surgeons. OrthoInfo. Distal Femur (Thighbone) Fractures of the Knee. Reviewed June 2011.

Additional Reading

  • 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.