Femur fracture treatment
Femur fracture, which is a complete or partial break in any part of the thighbone, is caused by significant force or trauma to the bone, as this is one of the strongest bones in the body. The right method of treatment for your femur fracture is determined by a number of elements, including age, past and present health, the severity of the fracture and history with various medications and other types of treatments.
A femur fracture can be particularly dangerous because of the number of blood vessels in the bone and the risk a break can pose to surrounding muscles. If you believe that your thighbone may be broken or injured, it is important to seek medical attention. To diagnose the possible fracture, your doctor will ask you a number of questions about your medical history and the activities that led to the injury. Next, the doctor will perform a brief physical exam. Because this is one of the longest bones in the body, one or more of these imaging tests will help determine the exact location and extent of damage from the fracture:
- X-ray (radiograph) – This is likely the first test that will be performed. In an X-ray, radiation will pass through your body and create images of your pelvis, thighbone or knee in order to check if not only the femur, but also the surrounding joints are stable. Typically anteroposterior and lateral views are enough to see any breakage or abnormalities.
- Angiography – This is performed when there is suspected damage to the blood vessels. In this test, contrasting material will be injected into the site of the injury and another X-ray will be taken to get a better view of damage to the blood vessels.
- Computed tomography scan (CT or CAT scan) – A CAT scan combines X-ray technology and computers to create an enhanced image of the fracture. This image is usually taken when there is concern that the fracture has spread to surrounding joints
Infrequently, femur fractures can be treated without surgery. These types of fractures will typically not have any damage to the surrounding joints, blood vessels or nerve endings and therefore will have a high probability of healing on their own. A femur fracture that is treated using nonsurgical means will require bed rest as weights and pulleys are used to create traction or the patient will be placed in a cast from rib cage to toes. These methods are usually used on pediatric patients or patients not medically able to undergo surgery.
In almost all cases, a femur fracture requires surgery. The goal of most femur fracture surgeries is to guide the bones into place so they heal properly. The majority of femur fractures are treated in one of these three ways:
- Metal plate with screws – In this type of surgery, a plate is placed alongside the breakage to hold the bone in place while it heals. Screws keep it stable so that it does not move around or shift during the healing process, making it more stable.
- Intermediary nailing – This is the most common surgery performed on femur fractures. A rod is placed down the middle of the bone through the marrow canal to hold it in place and keep it aligned so the bone heals straight. Then, screws are used at both ends to keep it in place.
- External fixation – In some cases, it may be too dangerous to place internal fixation rods or plates and screws. In this situation, external fixation is used. This method puts pins through the bone and out through the skin remote to the fracture site. These pins are then connected by carbon fiber rods to stabilize the fracture. External fixation may be used as definitive fixation or as provisional fixation until the patient is ready for internal fixation.
The multidisciplinary team of trauma experts at Northwell Health Orthopaedic Institute performs femur fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.