The femur, or thigh bone, is the longest and strongest bone in the human body, supporting body weight and facilitating movement from the pelvis to the knee. Despite its strength, capable of supporting up to 30 times a person’s body weight, a femur can break, typically requiring substantial force.
How Femur Fractures Happen
Femur fractures commonly result from high-impact trauma. Frequent causes include motor vehicle collisions, falls from significant heights, or direct blows like gunshot wounds.
The mechanism of injury dictates the fracture pattern. A transverse fracture is a straight horizontal break, while an oblique fracture presents an angled break. A spiral fracture occurs from a twisting force, winding around the bone. Comminuted fractures involve the bone shattering into three or more pieces.
Recognizing a Femur Fracture
Immediate, intense pain is a primary symptom, often making it impossible to bear weight on the affected leg. The thigh may show visible deformity, appearing crooked or shorter than the uninjured leg, with significant swelling and bruising. In severe cases, bone fragments may protrude through the skin, indicating an open fracture.
Diagnosis involves a physical examination and imaging tests, primarily X-rays, to confirm the fracture’s location and severity. CT scans or MRIs may be used for more detailed assessment.
Treatment and Rehabilitation
Treatment for a femur fracture almost always involves surgery to stabilize the bone. Internal fixation, using metal rods, plates, or screws, holds the bone in alignment as it heals. An intramedullary nail, a rod placed inside the bone’s marrow canal, is often used for shaft fractures. Sometimes, external fixation is applied temporarily, with pins inserted into the bone connected to an outside frame.
Rehabilitation begins after surgery with early movement to prevent complications like blood clots. Physical therapy focuses on pain management, restoring range of motion, and strengthening muscles. Weight-bearing is initially restricted, progressing to partial and then full as healing advances. Full recovery can take several months, and consistent physical therapy is important for optimal functional return.
Factors Increasing Fracture Risk
While significant force is typically required, certain conditions increase susceptibility to a femur fracture from less severe trauma. Osteoporosis, which causes bone weakening and reduced density, makes bones fragile and prone to breaking even from a simple fall. Certain bone diseases, like bone tumors, can also compromise bone integrity. Advanced age also contributes to vulnerability due to natural bone density loss and increased likelihood of falls. Severe malnutrition can also weaken bones.