Femur Fractures: A Closer Look at Types, Causes, and Treatments

Fractures of the femur pose a serious health problem, especially for senior citizens and people who participate in activities with a high risk of impact. Although the treatment methods have been enhanced by progressing healthcare technology, it’s very important for individuals and their families to know about what causes these fractures, their signs, treatment alternatives, and the healing process.

What are Broken Femurs?

Broken femurs, or femoral fractures, are common injuries treated by orthopedic surgeons. The femur, the strongest bone in the body, can be broken with immense force, causing blood loss, shock, hip fractures, and knee damage, particularly in individuals with osteoporosis or knee replacements, necessitating immediate pain medication or surgery.

They emerge from high-energy mechanisms such as car accidents, and they are frequently connected with multiple traumas that may lead to severe injuries. This kind of fracture occurs bimodally; it appears in young people as a result of high-energy trauma, while it appears in older people due to low-energy trauma. Annually, this type of injury has an incidence rate between 10 and 21 fractures per 100,000 people globally, out of which 2% are open. In men, the most affected age ranges between 15 and 35 years old, while among women there is a gradual increase starting from the age of 60. A large proportion of FSFs (femoral shaft fractures) resulting from car accidents or other sources involving trauma tend to occur among males compared to females who have these injuries because of falls at ground level.

Femur Fracture Types

Depending on the force that triggers the fracture, femur fractures are very different. The bone pieces may be properly aligned (stable fracture) or not aligned (displaced fracture). The skin around the fracture may still be undamaged (closed fracture), or bone may puncture the skin (open fracture). Doctors use classification systems to describe fractures to each other. There are different classifications of femur fractures based on location of fracture, fracture pattern, and skin or muscle involvement.

The most prevalent types of femoral shaft fractures consist of:

• Oblique fracture: The shaft of this type of fracture has an oblique line across it.
• Transverse fracture: For this type of fracture, the break is a horizontal line right through the shaft of the femur.
• Comminuted fracture: With this type of fracture, the bone has become broken into three or more pieces (usually). Most times, the number of fragments correlates with how hard it was to break it.
• Spiral fracture: With this sort of fracture, the fracture line is like candy cane stripes around the shaft. The twisting force on the thigh causes this kind of fracture.
• Open fracture: An open fracture is defined as one where bones stick out through skin or a wound goes down to broken ones; in other words, it can also be called a compound fracture. These open ones are often more destructive to neighboring muscles, tendons, and ligaments than closed ones. In addition, they are at a greater risk for complications (particularly infections), and they require a longer period for complete healing.

Femur Fracture Symptoms & Signs

Femur fractures can be open or closed, with open fractures causing bleeding and closed fractures pushing the bone against the skin without piercing it. Moreover, the symptoms of a femur fracture include

• Severe pain.
• Inability to bear weight.
• Swollen or bruised thigh.
• Bent or twisted leg.
• Loss of sensation.
• Tenderness at the injured site.

Femur Fracture Causes

There is not only one specific cause for the femur fractures. This is because a person’s situation can be different from another’s when it comes to causes of femur fractures. Some of the common causes of femur fractures include:

• Accidents
• Sudden falls
• Injuries due to sports
• Violence

In addition to the above traumatic causes, there are several medical conditions that might lead to femur fractures, such as:

• Bone malignancies
• Osteoporosis
• Heavy usage of corticosteroids

Diagnosis of a Femur Fracture

Diagnosing a femur fracture involves several methods, such as:

• Medical and physical examination: The doctor needs to know what caused it, whether it is associated with any underlying medical conditions, and if there are any injuries involved. Thus, a physical examination will be done where only the particular leg will be examined for any deformities, skin tears, bruises, or foreign bodies pressing against the surface of the skin.
• Imaging tests: For assessing fractures, imaging tests like x-rays and CT scans are utilized. In x-ray imaging of bones, images appear without distortion, which helps to see their condition and positions within a femur. The cross-sectional representation of this limb made by CT scans indicates the amount of damage done to it and the visibility of delicate splits in these structures.

Femur Fracture Treatment

Femoral fractures can either be treated operatively or non-operatively. The preferred method for treating patients is operative fixation using intramedullary nailing, which has been seen to be the gold standard of management there. Plate osteosynthesis and external fixation are other practices classified as operative. The above procedures are detailed below:

• Open Reduction Internal Fixation (ORIF): The most commonly used surgical procedure for femur fractures is ORIF. It entails making an incision, aligning broken bones, and fixing them in position using different types of metal plates, screws, or rods to hold the bones together.
• Intramedullary nailing for femoral shaft fractures: Intramedullary nailing is currently the most common way that surgeons treat femoral shaft fractures. This procedure involves the insertion of a metallic rod designed for such a purpose into the cavity of the femur. The rod lies across a fracture, keeping its position.
  Titanium is a commonly used material to manufacture the intramedullary nails. They are manufactured in a variety of lengths and diameters to accommodate the majority of femur bones.
• External fixation: External fixation refers to a type of surgery where metal pins or screws are inserted into the bone above and below the site of the fracture. These pins and screws are linked to a rod outside the skin to form a stabilizing frame that holds the bones in place.
  External fixation is usually a temporary treatment for femur fractures. An external fixator provides good, temporary stability until the patient is healthy enough for the final surgery. In some cases, an external fixator is left on until the femur is fully healed, but this is not common.
• Metal plates and screws: Upon this undertaking, initially, the bone pieces are restored (or their usual setting). They are held in place by metal plates and screws on the outside of these fragile bones.

When there is no option for intramedullary nailing, such as fractures in the hip joint or knee joint, then plates and screws are employed. Nonsurgical approaches are used for femur fractures if they are not severe or cause less injury, involving:

• Rehabilitation techniques.
• Usage of assisted or supportive devices.
• Immobilization techniques.
• Exercises.
• Usage of pain medications.

Femur Fracture Recovery Time

Broken femurs heal within a period of four to six months after the surgery. The first step is a clot, which provides a temporary framework for healing. Cells are called upon by the immune system to clear the damaged tissues. Between day 5 and day 11, new bone and cartilage networks are created. The period from day 11 to 28 sees the hardening of cartilage, enabling complete remaking of the bones as was before. As time elapses, the bone starts remaking itself, gradually becoming the ordinary kind of bone. The total recovery duration can be months or sometimes years.

Conclusion

A femur fracture can impair an individual’s movement and result in considerable impairment of his or her quality of life. They are difficult to get through, but adequate management and rehabilitation may result in functional recovery and a regain of strength.
Yashoda Hospitals, Hyderabad, offers top-notch treatment with experienced orthopedic doctors and surgeons, including invasive and minimally invasive surgeries. The Institute of Orthopedics and Joint Replacement uses advanced technology and modern facilities, making it a top hospital.

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