Femoral Shaft Fractures
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By: Genesis Villaneuva, PT, DPT
What is a Femoral Shaft Fracture?
The Femur (thigh bone) is the largest and strongest bone in the body. A femoral shaft fracture is a break anywhere along the straight part of the femur bone. Because of the strength of the bone, fractures are often severe, and involve life-threating injuries as they are often involved with high velocity or trauma.
Types of Femoral Shaft Fractures
Fractures are classified based on their location within the femur, the pattern of the fracture, and whether the skin has been broken. A femoral shaft fracture is differentiated from a femoral neck fracture, as the location of a femoral neck fracture occurs when the ball of the femur is separated from the rest of the bone.
The most common types of femoral shaft fractures include:
- Transverse – a straight horizontal break across the shaft
- Oblique – an angled line across the shaft
- Spiral – diagonal lines that encircle the shaft like that of a candy cane
- Comminuted – the bone has broken into three or more pieces
- Open – the skin has broken at the site of the fracture
Who is the most “”At Risk”” for a Femoral Shaft Fracture?
in the elderly population or those with osteopenia and osteoporosis, Femoral Shaft Fractures can occur from a low velocity injury such as a fall.
Signs of a Possible Femoral Shaft Fracture
Typical signs and symptoms of a femoral shaft fracture could include:
- Inability to bear weight on the leg
- Swelling
- Tenderness over a specific area of the thigh
- An obvious deformity or odd angle of the leg including being shorter than the other leg
- Groin pain
- Walking with a limp
Diagnosis of Femoral Shaft Fractures
Diagnosing a femoral shaft fracture is usually done with an X-Ray. An X-ray will often determine whether the bone is broken, the location of the fracture, and the type of fracture.
Occasionally, a CT (Computerized Tomography) is performed in order to get more detail about a potential fracture. This could help identify whether there is presence of a femoral neck fracture or if there are very fine or small fractures present which could be missed on an X-ray.
How Do You Treat a Femoral Shaft Fracture?
Treatment for a femoral shaft fracture is usually surgery, as soon as possible (typically within 24-48 hours. Occasionally in children, if the fracture is stable, then a cast may be the treatment option. During the waiting period between fracture and surgery, a patient may be put in traction which will help to keep the bones in a stable and aligned position or they may be put in a temporary cast.
Some of the different types of repairs done to a femoral shaft could include:
- External fixation – this is usually a temporary fix until a patient with other life threating injuries is ready for a more extensive surgery. Pins and screws are put in above and below the fracture site and then attached to a bar outside of the skin.
- Intramedullary nailing – a metal rod, typically made of titanium is put into the canal of the femur and passes through the fracture site to help keep it stable.
- Plates and screws – once the fractures bones are put into the correct position they are held into place by screws and metal plates that are attached to the surface of the bone, under the skin.
Rehab After a Femoral Shaft Fracture Repair
Extensive rehabilitation will be necessary after surgery, and Physical Therapy is an important part of the recovery process. There is often a weight bearing restriction after surgery. A physical therapist will educate patients on the amount of weight to apply, and help choose the proper assistive device necessary to maintain the safety of the repair. Physical therapy will focus on limiting muscle and strength loss from immobilization, and will develop a structured exercise plan that will progress rehabilitation based on the stage of condition of injury.
Related links:
If you have an injury or possible fracture, the Jacksonville Orthopaedic Institute can help! To see a JOI Orthopedic Doctor, call (904)JOI-2000, schedule on line, or click the link below. To see a JOI Rehab Therapist is 1 of our 12 locations, call (904)858-7045.
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