A broken femur, the thigh bone, is a significant injury. As the body’s largest, strongest, and heaviest bone, it connects the hip and knee, supporting body weight and enabling movement. Fractures typically result from substantial force, such as car accidents or significant falls. However, even a minor fall can cause a femur fracture in older individuals with weakened bones. This injury demands prompt medical attention for proper healing and to prevent complications.
Initial Hospital Care and Assessment
Upon arrival at a medical facility with a suspected femur fracture, immediate steps focus on stabilizing the patient and the injury. Healthcare providers prioritize assessing the patient’s airway, breathing, and circulation. They also evaluate for any other associated injuries or potential bleeding sources.
Initial stabilization measures include applying traction or splinting to reduce pain and prevent further damage. Pain management is also a priority, with medication administered to alleviate discomfort. To confirm the diagnosis and determine the fracture’s severity, imaging studies such as X-rays and computed tomography (CT) scans are performed. These tests help identify the specific type of femur fracture.
Surgical Fixation Methods
Repairing a broken femur requires surgical intervention to realign bone fragments and secure them for proper healing. The most common method for many femur shaft fractures is intramedullary (IM) nailing. This procedure involves inserting a metal rod, or nail, into the hollow center of the femur, known as the intramedullary canal. The rod spans across the fracture line, providing internal support and stability.
During IM nailing, the surgeon makes a small incision near the hip or knee to insert the rod. Screws then secure the rod at both ends of the bone, holding the fragments in correct alignment. This internal fixation allows the bone to heal while maintaining its length and rotation. The procedure aims to minimize disruption to surrounding soft tissues.
Another surgical approach involves plates and screws, known as open reduction and internal fixation (ORIF). In this technique, the surgeon repositions the bone pieces into proper alignment through an incision. Metal plates are then positioned along the bone’s surface and secured with screws to hold the fragments together. This method is useful for certain fracture types or locations, such as those near the hip joint or when an IM nail is not suitable.
In some situations, such as significant soft tissue damage, excessive swelling, or multiple injuries, an external fixator is used. This temporary measure involves placing metal pins or screws into the bone above and below the fracture site. These pins connect to a bar outside the skin, creating a stabilizing frame that holds the bone in position. External fixation is a short-term solution, allowing tissues to heal before a more permanent internal fixation method is employed.
Life After Surgery: Recovery and Rehabilitation
Following surgical repair of a femur fracture, recovery begins with immediate post-operative care. This includes managing pain and caring for the surgical wound. Patients can shower within 5 to 7 days after surgery, ensuring the incision remains clean and dry.
Physical therapy plays an important role in regaining mobility and function. Therapists guide patients through exercises that improve range of motion, strengthen surrounding muscles, and enhance balance. While some patients can begin gentle movement and weight-bearing activities shortly after surgery, progression is gradual and depends on the fracture type and stability of the repair. Full recovery from a femur fracture can take 3 to 12 months. Adherence to rehabilitation protocols is important for successful outcomes.