Conditions & Treatments
Your thigh bone (femur) is the longest and strongest bone in your body. Because the femur is so strong, it usually takes a lot of force to break it. Car crashes, for example, are the number one cause of femur fractures.
Femur fractures vary greatly, depending on the force that causes the break. The pieces of bone may line up correctly or be out of alignment (displaced), and the fracture may be closed (skin intact) or open (the bone has punctured the skin). Femur fractures are classified depending on:
- The location of the fracture (the femoral shaft is divided into thirds: distal, middle, proximal)
- The pattern of the fracture (for example, the bone can break in different directions, such as cross-wise, length-wise, or in the middle)
- Whether the skin and muscle above the bone is torn by the injury
The most common types of femoral shaft fractures include:
- Transverse fracture – The break is a straight horizontal line going across the femoral shaft.
- Oblique fracture – The fracture has an angled line across the shaft.
- Spiral fracture – The fracture line encircles the shaft like the stripes on a candy cane. A twisting force to the thigh causes this type of fracture.
- Comminuted fracture – The bone has broken into three or more pieces.
- Open fracture – If a bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open or compound fracture. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications — especially infections— and take a longer time to heal.
A femoral shaft fracture usually causes immediate, severe pain. You will not be able to put weight on the injured leg, and it may look deformed — shorter than the other leg and no longer straight.
Most femoral shaft fractures require surgery to heal. It is unusual for femoral shaft fractures to be treated without surgery. If the skin around your fracture has not been broken, your doctor will wait until you are stable before doing surgery. Open fractures exposed to the environment urgently need to be cleansed and require immediate surgery to prevent infection. For the time between initial emergency care and your surgery, your doctor will place your leg either in a long-leg splint or in skeletal traction. This is to keep your broken bones as aligned as possible and to maintain the length of your leg.
Skeletal traction is a pulley system of weights and counterweights that holds the broken pieces of bone together. It keeps your leg straight and often helps to relieve pain.
External fixation. In this type of operation, metal pins or screws are placed into the bone above and below the fracture site. The pins and screws are attached to a bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal.
Our orthopaedic trauma surgeons at Emory utilize these types of surgery to treat femur fractures:
- External fixation
- Intramedullary nailing
- Plates and screws
Most femoral shaft fractures take 4 to 6 months to completely heal. Some take even longer, especially if the fracture was open or broken into several pieces. You will lose muscle strength in the injured area. Physical therapy will help to restore normal muscle strength, joint motion, and flexibility.
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