How To Treat A Femur Fracture And Other Things You Need To Know

The femur is the longest  bone in the human body. It runs from the knee to the hip socket, ending at the top with the ball portion of your hip joint, and is sometimes called the thigh bone. A femur fracture is when a portion of the femur breaks. The location and pattern of a femur fracture dictate what it is called, but a fracture of the thigh bone is always a serious condition requiring medical treatment.


What Is a Femur Fracture?

When you fracture the thigh bone at any point, including the ball-end that makes up part of your hip, you have suffered a femur fracture. These symptoms may indicate a fractured femur, and you should seek medical attention if you experience one or more of them after a fall, accident, or severe impact:

  • A misshapen or mis-aligned thigh
  • Intense, sudden pain in your thigh or hip
  • An injured leg that appears shorter than the other one

Types of Femur Fractures

Fractures of the thigh bone are named based on the location of the bone where the break occurs as well as the fracture pattern. Although we discuss some common types of femur fractures here, this list is not exhaustive and may not cover specific, less common, types of fractures.


Proximal Fractures

These are fractures of the femur that are close to the top (hip) end of the bone. They are often referred to as hip fractures because of their location and can include fractures of portions of the hip joint or upper femoral shaft. Femoral neck fractures are a type of hip fracture where the ball end of the femur breaks off. This usually requires surgery to fix.


Femoral Shaft Fractures

This is where the long, straight part of the femur is broken. These are often caused by a severe impact, such as from a motor vehicle accident or extreme fall. The direction of the break may be classified as spiral (twisting), transverse (horizontal), or oblique (diagonal) along the length of the bone. Regardless of the pattern it displays, surgery is almost always required to repair this type of fracture.


Supracondylar Fractures

These are fractures that occur at the lower end of the femur, close to the knee joint. They often involve damage to the cartilage of the knee, and can lead to an increased likelihood of developing arthritis in that joint. A fracture in this region is less likely than at other points in the femur, and may be more prevalent in people who have had total knee replacements in the past.


Causes of Femur Fractures

Femur fractures are not a common occurrence in healthy and active individuals, and may be a sign of other skeletal problems. There are several situations where femur fractures are more likely to occur, such as having osteoporosis, when taking certain medications which can weaken bone structure, and experiencing persistent infections. However, the most common cause of fractures in the femur are from motor vehicle accidents.


Motor Vehicle Accidents

Motor vehicle accidents are the number one cause of fractures in the thigh bone. Because of the naturally strong makeup of the femur, it takes a great deal of force to break it, particularly along the length of the femoral shaft. Being involved in a motor vehicle or motorcycle accident, or being struck by a moving vehicle, creates enough force to result in such a fracture.


Extreme Falls

Although a fall from a few feet isn’t likely to result in a femur fracture, a fall from extreme heights or a ladder very well might. People who experience a fall of this type are more likely than others to suffer a fracture in their femur.


Bone Loss

A femur fracture is unlikely in someone who has a healthy and strong bone structure. However, even a slight fall from standing can result in a fractured femur in someone with bone loss due to conditions such as osteoporosis. Osteoporosis is a medical condition characterized by decreasing bone density. This causes the bones to become weakened or brittle, which makes a fracture in the femur more likely. While many people associate osteoporosis with age, new research indicates that lifestyle choices such as diet and exercise may play a role in the condition.

Bone loss can also be caused by chronic infection and several other common conditions, such as asthma, inflammatory diseases, and possibly diabetes. Prolonged exposure to certain medications, including some bisphosphonate drugs used to treat osteoporosis, can also lead to bone loss and an increased risk of femoral fractures.


How to Treat a Femur Fracture

As we mentioned earlier, when a portion of the femur breaks or is fractured, it is a serious situation and medical treatment should be sought as soon as possible. There are several common and noninvasive diagnostic techniques used to determine if a fracture has occurred as well as the best course of treatment. Most fractures that involve the femur require surgery to repair, although, in rare cases, some may be treatable with braces or other non-invasive, external supports. All treatment methods rely on the body’s natural ability to heal itself.


Diagnostic Procedures

When you seek medical attention for a suspected fracture of your femur, you will probably have the area fully examined by a doctor before any tests are ordered. In the case of a compound fracture, where the bone is sticking through the skin, there will be little doubt of the presence of a fracture. However, most breaks are not so obvious. Once a physical exam is completed, you may experience one or more diagnostic procedures.

A standard X-ray will often be the first imaging tool used in diagnosing a fracture. It allows doctors to know if a fracture has occurred, as well as the pattern and location of the break. In some cases, doctors will also order a computerized tomography (CT) scan. These show cross sections of bone, allowing a more realistic, 3-D image of the fractured area. Both of these tools show bone well, but do not provide information about surrounding soft tissue.


Nonsurgical Treatments

In some cases, it may be possible to use nonsurgical options to treat a fractured femur. This is not common, however, and should not be an expected course of action. Examples of thigh fractures that can be treated with noninvasive methods include certain types of femoral shaft fractures in children and a limited number of supracondylar fractures.

Supracondylar fractures may be treated with braces or casts, although rods, plates and screws, or external fixators are more likely treatment options. In the case of very young children (under 5), a brace or cast may be used to treat some femoral shaft fractures. This is largely due to increased rates of healing and bone growth in young children. When bone displacement is more than 3 cm, surgery will likely be recommended and performed.


Surgical Treatment Options

There are several surgical treatments for fractured femurs. These include the use of external fixators, plates and screws, and rods inserted into the bone shaft.

Intramedullary rods are the most common surgical treatment option, particularly for a femoral shaft fracture. These are thin metal rods that are inserted into the shaft of the femur to join the broken pieces together. They are held in place with screws above and below the injury site. The metal components are generally left in the leg unless they cause discomfort after healing is complete. Plates are a similar treatment option that are applied to the outside surface of the bone instead of through its center. They are also secured with screws to ensure stabilization of the bone while it heals.

External fixators are small links that are placed outside the skin. They are connected to the femur by metal pins or spikes. This is often a temporary fix that allows doctors to fully stabilize the injured femur in a patient that has extensive soft tissue injuries or who is not strong enough for a more involved surgery.


Pain Management

No matter what treatment option is chosen, pain management will allow someone with a femur fracture to be more comfortable. Many pain medications can also reduce swelling, which allows the body to heal more quickly.


Physical Therapy

As with most fractures, physical therapy will be necessary to regain full use of the affected area. Physical therapists will guide you through exercises to increase flexibility, muscle tone, and range of motion. Some exercises may also help reduce pain in the affected area.


Conclusion

Fractures in any of the major bones can be devastating and limit your mobility. A femur fracture is no different. A break can happen at any point along the thigh bone, and may require complicated surgery installing rods, plates, or screws to repair it.

Although healthy, active people generally have strong femurs, they may experience breaks from severe impacts or extreme falls. Individuals with weakened or porous bone structure can fracture their femur much more easily, even with a slight fall from standing. Care should be taken by anyone with osteoporosis to avoid hip or femur fractures which could lead to invasive surgeries, extended recovery periods, and restricted mobility.