What is the Femur?

The femur is your upper leg or thigh bone, among the longest and sturdiest in your body. It is the only bone connecting your pelvic region, via the hip joint, to your tibia or primary ankle bone at the knee joint. You have two femurs (or femora), one in each leg. The femur plays a major role in supporting the body when walking or standing upright. A fractured or broken femur can be painful, slow healing, and a source of medical and other difficulties in daily living. 

Types of Femur Fractures and Breaks 

The femur can be divided into three parts: the proximal or upper end, the main body or shaft, and the distal or lower end. All three parts are susceptible to breakage. Common types of femoral fractures include: 

• Transverse fracture: a straight-line break running horizontally across the shaft.
• Oblique fracture: a straight-line break running at an angle across the shaft.
• Spiral fracture: a circular break extending vertically along the circumference of the shaft. Spiral fractures are caused by a twisting rather than an intercepting force.
• Comminuted fracture: a break that results in three or more pieces of bone (e.g., the main shaft in two parts plus one or more bone fragments).
• Compound fracture: a break that exposes bone to the air through penetration of the skin. 
• Open fracture: a deep wound extending to the bone. Open fractures involve damage to muscles, ligaments, and tendons, in addition to the bone, and run the risk of infection and other serious medical complications. 

Fractures also occur at the proximal and distal ends of the femur. Proximal breaks can result in problems with hip mobility; distal breaks, in knee damage and arthritic conditions.

Femur Fracture and Break Symptoms

The strength of a healthy femur means that considerable force is required to break it – typically, a major accident such as a car wreck or a serious athletic injury. Certain medical conditions, such as osteoporosis, can weaken the bone to the point that it is more easily fractured. Older persons can experience a break simply by falling. 

The following symptoms may indicate a femur break or fracture:

• Severe and immediate pain following an accident, collision, or fall
• An inability to put weight on an injured leg
• The crooked appearance of an injured leg
• One leg being shorter than the other following an accident, collision, or fall

Diagnosis and Outlook

Diagnosing a broken femur typically involves a medical examination and imaging tests, such as X-rays or CT scans. Your physician can use these images to verify the location, nature, and extent of the fracture. 

Most femur breaks are serious enough to require a high degree of medical intervention, including medications, immobilization, and repair surgery. The purpose of these interventions is to assist the body in its natural healing process and to make you more comfortable while it occurs. The prognosis or outlook of femur fractures is generally positive. Most patients recover fully, though recuperation can be time-consuming. 

Treatment and Recovery

There are a variety of medical options available for treating persons with a femoral fracture.

Non-surgical Treatment

Broken thigh bones in young children are sometimes treated non-surgically. Physicians can address the fracture by immobilizing the leg in a cast for an extended period of time.

Surgical Treatment

A majority of femur breaks require surgery for proper healing:

• Timing: Most surgical procedures take place within 24 to 48 hours of the injury that caused the fracture, unless a more serious medical condition takes precedence. Prior to surgery, the physician will immobilize the broken leg with a splint or traction device. 
• External fixation: One procedure used to address a fracture is the insertion of metal pins or screws into the femur above and below the break. These pins are anchored in a frame that is fitted to the outside of the body. The purpose of the frame is to hold the femur in proper alignment. External fixation is typically a temporary fix that requires additional surgeries at a later date. 
• Intramedullary nailing: This surgery involves the insertion of a metal rod along the length of the femur shaft. The rod helps to maintain the alignment of the femur during the healing process. It is a permanent addition to the body. 
• Plates and screws: Plates and screws are used to reassemble the bone in those cases where the injury resulted in multiple bone fragments. As with intramedullary nailing, these are permanent additions to the body.

Recovery

The recovery period for a femoral fracture typically runs from three to six months. These are some of the issues that you can expect to deal with during recovery:

• Pain management: Pain is common following major surgeries like those for a femoral fracture. Your physician will work with you to find ways to reduce and control the pain. There are a variety of medications available for pain relief. Some of these, including the opioids, can be addictive or have other, undesirable side effects. 
• Leg use: Your physician will instruct you on when and how quickly you should put weight on and walk using your injured leg. You may require the assistance of crutches until you’re more fully recovered. 
• Physical therapy: Not using a limb for any period of time can lead to muscle loss. Your physician may arrange for you to undergo physical therapy, to restore muscle strength and joint mobility. 

Femoral fractures sometimes lead to medical complications based on the injury itself and on the surgical procedure required to correct it. If you continue to experience pain or difficulties with leg function following recovery, be sure to let your physician know. 

At Baptist Health, We’ll Give You a Leg Up on Surgery

Baptist Health is a leading provider of orthopedic care in Kentucky and Southern Indiana. Contact a Baptist Health facility in your area to see how we can help .