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Several x-rays will be taken, and many times, your doctors will need to get a CT scan of other body parts. If this is the case, doctors may put something called a "traction pin" into your leg bone above or below your knee and connect this pin to a rope with weights.
This is done at the bedside under local numbing medicine. The weights can help to temporarily line up the broken ends of the bone, which can help your leg feel better before surgery. Femur fractures almost always require surgery.
The most common way to stabilize or "fix" your broken femur is to place a metal rod, called an "intramedullary nail" "IM nail" for short inside the hollow center tube of your femur. Based on factors including other injuries you may have, doctors may choose to put the rod into your femur from the top of the bone near your hip or from the bottom of the bone near your knee. Typically, one or more screws will be placed through holes in the rod above and below the fracture.
Because the rod and screws are placed using x-ray guidance, doctors can usually perform the surgery through several small incisions cuts in your skin. The rod and screws will stabilize your broken femur, and often you will be allowed to put weight on your injured leg right after surgery. This decision will be made by your surgeon. The most common reason for this is the presence of hardware in your femur, such as a hip replacement or knee replacement.
Sometimes, doctors may need to temporarily stabilize your femur fracture with something called an external fixator. This procedure will be performed in the operating room, and involves placing metal pins through the skin and into the bone above and below the fracture.
The ends of the pins remain outside your body, and they are connected with bars and clamps, which stabilize the fracture. At some point the external fixator can be removed and your femur may be fixed with a rod or plate and screws. After your femur fracture is fixed, you will probably need to stay in the hospital for a few days. During this time, nurses and therapists will help you begin walking again. Depending on your fracture pattern and how it was fixed, your doctors may place some restrictions on weightbearing.
In either case, you will probably need to use crutches or a walker for a while, and you may need to go to a rehabilitation facility or skilled nursing facility. Other exercises can be done to keep your hip and thigh muscles strong during the recovery process.
After a few weeks, the stitches or staples used to close the surgical incisions will be removed. X-rays will be taken at different time points to make sure the fracture heals.
You may need to do additional physical therapy to build up your strength and balance. Femur fractures fixed surgically usually heal. Your doctors may see signs of healing on x-rays about 6 weeks after surgery, but it normally takes 3 months or more for the femur to fully heal.
This surgery would usually include placing additional hardware and may require bone grafting. Most of the time, once your femur fracture heals, you will be able to return to all of the activities you were able to do before your injury. The doctor must be known of the particular details regarding the injury. These details will greatly help a doctor to determine the reason and mechanism of injury. After a comprehensive understanding of injury and medical history, a doctor needs to do a careful examination and assessment of the overall condition.
While physical examination, a doctor should check:. After examining these conditions, a doctor must feel for pulses. If the patient is awake, sensation, and movement in the leg and foot must be examined. However, in most cases, femur shaft fractures need surgical treatment.
But in some cases, non-surgical treatment can be given. Sometimes, a cast is used in the case of very young children. Timing of surgery- In the case of surgical treatment, femur fractures should be fixed within 24 to 48 hours. Fixation can be delayed so long as other life-threatening injuries or unstable medical conditions are stabilized.
Open fractures should be treated with antibiotics as soon as the patient is admitted to the hospital so that the risk of infection can be minimized. The open wound, bone, and tissues, must be cleaned during surgery. Prior to surgery, a doctor can place the leg either in a long-leg splint or in traction as emergency management of the fracture. Skeletal traction is a pulley system of weights and counterweights that holds the broken pieces of bone together. It keeps the leg straight and also helps in relieving the pain.
It keeps the broken bones as much aligned as possible and to maintain the proper length of the leg. For external fixation, metal pins or screws are placed into the bone above and below the fracture site to hold the bone inadequate position. These pins and screws are attached to a bar outside the skin thus, this device is a kind of stabilizing frame for the fractured bone.
Generally, external fixation is a temporary treatment for femur fractures. Since they can be applied easily. Sometimes an external fixator can be left on until the femur is fully healed completely but it requires rarely. Intramedullary nailing is the most widely used method for treating femoral shaft fractures. Usually, intramedullary nails are made of titanium.
They are available in different lengths and diameters to fit most femur bones. In this procedure, a metal rod designed specifically is inserted into the femur canal. Intramedullary nails can be inserted into the canal either at the hip or the knee. The rod passes across the fracture such that it can keep it in position. To hold the leg in correct alignment, screws are placed above and below the fracture. Plates and screws are usually applied when intramedullary nailing is not possible as in case of fractures that extend into either the hip or the joints of the knee.
During surgery, first, the bone fragments are reduced to the normal alignment. Bone fragments are held together with screws and metal plates are attached to the outer surface of the bone. A wide range of orthopedic implants and tools such as the tibia and femur interlocking systems are made available by orthopedic implant manufacturers.
Complete healing of most femoral shaft fractures may take 3 to 6 months. In some cases, healing time may be longer, particularly when the fracture is open or broken into many pieces or if the patient consumes tobacco products.
A doctor and nurses can work to reduce the pain, which can also facilitate a speedy recovery. After an injury or operation, pain is a natural part of the healing process. For short-term relief, medications are prescribed after an injury and surgery.
The medicines available for the management of reducing the pain include acetaminophen, gabapentinoid, nonsteroidal anti-inflammatory drugs NSAIDs , muscle relaxants, opioids, and other medication for topical pain. A doctor may prescribe a combination of medicines for pain relief, as well as to minimize the need for opioids.
A doctor can discuss with the patient the side effects of these medications. Since opioids are narcotics so can be addictive. However, they can relieve pain but must be prescribed carefully. The overdose and reliance on opioids is also a serious public health issue in the U. The use of opioids must be stopped once the pain starts to improve. If pain persists even after a few days of treatment, the patient should consult the doctor.
In some cases, doctors can encourage leg motion in the early recovery period. But in other cases, weight-bearing as much as possible on the leg is allowed by the doctor right after surgery. Though a patient may be unable to put full weight on the leg unless the healing process has started. The patient may need crutches or a walker for support once he starts walking.
Since a patient tends to lose muscle strength in the injured area, exercises during the healing process are very significant. Physical therapy facilitates the restoration of normal muscle strength, flexibility, and joint motion. It also helps in the management of pain post-surgery. The use of crutches or a walker is taught to the patient by the therapist. Femoral shaft fractures may result in further injury and complications which are as follows:.
Complications from Surgery Complications of surgery usually involve:. It is not stored on this sites database. Types of Femoral Shaft Fractures Generally, femur fractures can be classified on the basis of force applied, location and pattern of the fracture, and nature of the injury. On the basis of force causing the break: If the pieces of the bone line up correctly, it is a stable fracture, or if it is out of alignment then it is a displaced fracture.
On the basis of location: The femoral shaft is divided into three parts: distal , middle, proximal.
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