Just take this femur fracture recovery case study, in which a patient required the placement of a rod for a fracture in her left femur. Femoral shaft fractures are usually the result of high. Scribd is the worlds largest social reading and publishing site. Typical femur fractures will present in distinct ways. The limb will be shortened and rotated outward see photo 1. Seventy percent of femoral fractures involve the shaft. Associated ipsilateral femoral neck fractures have been reported to occur in as high as 10% of all femoral shaft fractures 1, 2. Fracture mechanisms and injuries causing traumatic femoral shaft fractures. Femoral shaft fracture, also known as broken thighbone, is the breakage of the shaft of the femur or thighbone.
In some cases, femoral shaft fractures require not only surgery, but the placement of a steel, intramedullary rod called an intramedullary rod. Open subtypes 3 open subtypes 3 multifragmentary fractures. Fracture of shaft femur free download as powerpoint presentation. Research article injuries associated with femoral shaft. Locking plate fixation in pediatric femur fracture. Breaking your femur can make daily tasks more difficult because its one. Ipsilateral femoral neck and shaft fractures, proximal fe moral nail, reduction, cephalomedullary nail background combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. Femoral shaft fracture in children not yet walking must raise suspicion for nonaccidental trauma. Healing of 56 segmental femoral shaft fractures after locked nailing. A femoral shaft fracture is defined as any fracture occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle. Fractures of the femoral shaft are mostly the result of highenergy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures. Femur fracture reaming reaming of the femoral shaft fracture only pape j trauma 1993 has shown a deleterious pulmonary effect to immediate reamed intramedullary nailing in acute femur fracture patients with pulmonary trauma in both a retrospective analysis and multiple animal studies pape, j trauma 1992.
Fracture, femoral shaft childrens hospital colorado. Okcu g, aktuglu k 2003 antegrade nailing of femoral shaft fractures combined with neck or distal femur fractures. In contrast, a too lateral entry point can result in varus. For claims with a date of service on or after october 1, 2015, use an. What is femoral shaft fracturetypescausestreatment. The annual incidence of femoral shaft fractures is approximately 10 per 100,000 people. Overview of the femur and pelvis fracture episode of care. Reduce the fracture to anatomic alignment and apply a spica cast. Injuries associated with femoral shaft fractures with special. It is important that your doctor know the specifics of how you hurt your leg. Femur shaft fracture an overview sciencedirect topics.
In high velocity injuries ipsilateral hip dislocation and acetabular fractures have to be excluded. Conventional teaching indicates that the femoral neck fracture potentially is the more problematic part of this pattern. In the treatment of these injuries, it is important to keep in mind that pediatric femoral fractures differ from adult femoral fractures in several key respects, and these differences affect management. However, alho 1,2 thought that the femoral shaft fracture was the main determining factor of the patients overall outcome. Pediatric femoral shaft fractures are one of the most common peditric orthopaedic fractures and are the most common reason for pediatric orthopaedic hospitalization. The combination of ipsilateral femoral shaft and tibial shaft fractures, producing a floating knee, signals a high risk of multisystem injury in the patient. Ipsilateral femoral neck and shaft fractures fixation with. A supracondylar femur fracture, also called a distal femur, is an unusual injury that occurs just above the knee joint. Ppt fracture of shaft of femur powerpoint presentation.
Splintage of the femoral fracture, initially in the form of. Femoral shaft fractures musculoskeletal medicine for. In children, proximal femoral fractures physeal, intertrochanteric and femoral neck fractures are less common than femoral shaft fractures but have higher rates of complication osseous necrosis all proximal femoral fractures should be referred to. Subsequent imaging in the trauma bay demonstrates a bifrontal cerebral contusion, an l4 burst fracture, multiple rib fractures, an lc1 type pelvic ring injury, a femoral shaft fracture, and an open ipsilateral tibial shaft fracture. There are ipsilateral knee injuries in 20%40% of patients and ipsilateral tibial fractures in approximately 10% of cases. Femoral shaft fractures occur most commonly in young men and elderly women following highenergy trauma and lowenergy falls, respectively. It is unusual for femoral shaft fractures to be treated without surgery. The long, straight part of the femur is called the femoral shaft. The long, straight part of the femur thighbone is called the femoral shaft. Because the femur is so strong, it usually takes a lot of force to break it.
The chapter uses the ssection for coding different types of injuries related to single body regions and the tsection to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes. Reduce the fracture to it pre fracture alignment and apply a spica cast. The ratio of males and females who suffered femoral shaft fractures was. The treatment of these fractures can vary greatly depending on the age of the patient and the fracture pattern. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone. Most femoral shaft fractures require surgery to heal. Fracture of shaft femur knee musculoskeletal system. A femoral fracture is a bone fracture that involves the femur. Femoral shaft fractures reportedly occur at a rate of approximately 20100,000 children in the usa, representing 1. To promote fracture healing, static fixation is sometimes changed to a dynamic one wiss et al. Car crashes, for example, are the number one cause of femur fractures. Femoral shaft fracture is a common traumatic musculoskeletal injures in pediatric population.
Do you want to use the redesigned ao sr like an app. Femur shaft fractures broken thighbone duke ahn, m. Femur shaft fractures broken thighbone orthoinfo aaos. There will be a bulge at the point of the break pointing to its location i. Pdf associated ipsilateral femoral neck fractures have been reported to occur in 1% to 9% of femoral shaft fractures. Femur shaft fracture treatment boston medical center. Over the years, femoral nailing is the overall gold standard in treating femoral shaft fractures. Usually occur in young men after high energy trauma and elderly women even after a low energy fall. Fractures associated with nonaccidental trauma tend to occur in the distal femur or in combination with the distal femur.
Arriving at the algorithm must be an aaos member to view aaos now and jaaos articles. Fracture of shaft of femur 1 fracture of shaft of femur 2. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. Management of femoral shaft fractures acta chirurgiae. Your thighbone femur is the longest and strongest bone in your body. Insofar as no operative technique had yielded consistently better results than casting, nonsurgical treatment continues to. It is a fracture of femoral diaphysis occurring between 5cm distal to lesser trochanter and 5cm proximal to adductor tubercle. Isbn 9521025239 pdf helsinki university printing house helsinki 2005. When the fracture extends far down the shaft towards the knee a plate may be used.
Treatment depends on the age, fracture pattern, and weight of the patient. Epidemiology, fracture patterns, nonunions, and fatigue fractures a clinical study sari salminen academic dissertation to be presented with the permission of. Pediatric femoral fractures may involve the proximal femur, the femoral shaft, or the distal femur. The greatest advantage of operative treatment of a fractured femur is that it allows the patient. The femoral shaft or diaphysis is the long straight middle section of the femur. Very young children are sometimes treated with a cast. Femur shaft fracture diagnosis boston medical center. Populationbased epidemiology of femur shaft fractures. Open subtypes 3 your digital gateway to expertise, education, and innovation.
Full clinical practice guideline pdf on the treatment of pediatric diaphyseal femur fractures. In up to 9% of femoral shaft fractures, there is an associated ipsilateral femoral neck fracture. Pdf femoral shaft fractures in adults researchgate. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. The femur, your thigh bone, is the largest and strongest bone in your body. Femoral shaft fractures orthopaedic trauma association. Do a femoral osteotomy to correct the deformity and fix it with flexible nails.
1402 1489 1451 1262 558 875 438 1455 1209 640 1449 226 1084 110 1160 693 953 759 1185 436 1453 536 810 282 1156 1139 630 846 279 865 494 473 524 1269 1450 809 769 1402 354 966 101 760 438 1395 385 931 1249