Over the years, femoral nailing is the overall gold standard in treating femoral shaft fractures. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. Overview of the femur and pelvis fracture episode of care. The annual incidence of femoral shaft fractures is approximately 10 per 100,000 people. Ipsilateral femoral neck and shaft fractures fixation with. The long, straight part of the femur thighbone is called the femoral shaft. The femoral shaft or diaphysis is the long straight middle section of the femur. For example, if you were in a car accident, it would help your doctor to know how fast you were going, whether you were the driver or a passenger, whether you were wearing your seat belt, and if the airbags went off. Scribd is the worlds largest social reading and publishing site.
Fracture of shaft femur knee musculoskeletal system. Open subtypes 3 your digital gateway to expertise, education, and innovation. Populationbased epidemiology of femur shaft fractures. Fracture, femoral shaft childrens hospital colorado. Fracture mechanisms and injuries causing traumatic femoral shaft fractures. In up to 9% of femoral shaft fractures, there is an associated ipsilateral femoral neck fracture. Your thighbone femur is the longest and strongest bone in your body. Associated injuries, diaphysis, femur, fracture, treatment. Fracture of shaft femur free download as powerpoint presentation. For claims with a date of service on or after october 1, 2015, use an. Intramedullary nailing for femoral shaft fractures in adults. Femur fracture reaming reaming of the femoral shaft fracture only pape j trauma 1993 has shown a deleterious pulmonary effect to immediate reamed intramedullary nailing in acute femur fracture patients with pulmonary trauma in both a retrospective analysis and multiple animal studies pape, j trauma 1992. In high velocity injuries ipsilateral hip dislocation and acetabular fractures have to be excluded.
It is a fracture of femoral diaphysis occurring between 5cm distal to lesser trochanter and 5cm proximal to adductor tubercle. The greatest advantage of operative treatment of a fractured femur is that it allows the patient. Femoral shaft fracture in children not yet walking must raise suspicion for nonaccidental trauma. Just take this femur fracture recovery case study, in which a patient required the placement of a rod for a fracture in her left femur. Associated ipsilateral femoral neck fractures have been reported to occur in as high as 10% of all femoral shaft fractures 1, 2. Ppt fracture of shaft of femur powerpoint presentation. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. The ipsilateral femoral neck and shaft fracture combination injury is a difficult treatment problem. In contrast, a too lateral entry point can result in varus. A femoral shaft fracture is defined as any fracture occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle. The femur, your thigh bone, is the largest and strongest bone in your body. Femur shaft fracture an overview sciencedirect topics. Splintage of the femoral fracture, initially in the form of. Full clinical practice guideline pdf on the treatment of pediatric diaphyseal femur fractures.
Femur shaft fracture diagnosis boston medical center. Do a femoral osteotomy to correct the deformity and fix it with flexible nails. The long, straight part of the femur is called the femoral shaft. In some cases, femoral shaft fractures require not only surgery, but the placement of a steel, intramedullary rod called an intramedullary rod. Femoral shaft fractures are usually the result of high. The treatment of these fractures can vary greatly depending on the age of the patient and the fracture pattern. Pdf associated ipsilateral femoral neck fractures have been reported to occur in 1% to 9% of femoral shaft fractures. When the fracture extends far down the shaft towards the knee a plate may be used.
Car crashes, for example, are the number one cause of femur fractures. Fractures associated with nonaccidental trauma tend to occur in the distal femur or in combination with the distal femur. Reduce the fracture to anatomic alignment and apply a spica cast. In the treatment of these injuries, it is important to keep in mind that pediatric femoral fractures differ from adult femoral fractures in several key respects, and these differences affect management. Open subtypes 3 open subtypes 3 multifragmentary fractures. Injuries associated with femoral shaft fractures with special. Most femur fractures are fixed within 24 to 48 hours. Em in 5 blog is a series of 5 minute emergency medicine lectures on high yield topics. In children, proximal femoral fractures physeal, intertrochanteric and femoral neck fractures are less common than femoral shaft fractures but have higher rates of complication osseous necrosis all proximal femoral fractures should be referred to. Isbn 9521025239 pdf helsinki university printing house helsinki 2005. Insofar as no operative technique had yielded consistently better results than casting, nonsurgical treatment continues to. It is unusual for femoral shaft fractures to be treated without surgery.
The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures. Diaphyseal femur fractures are mostly the result of highenergy trauma, for. Okcu g, aktuglu k 2003 antegrade nailing of femoral shaft fractures combined with neck or distal femur fractures. The chapter uses the ssection for coding different types of injuries related to single body regions and the tsection to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes. A supracondylar femur fracture, also called a distal femur, is an unusual injury that occurs just above the knee joint.
Femoral shaft fractures orthopaedic trauma association. Management of femoral shaft fractures acta chirurgiae. A femoral fracture is a bone fracture that involves the femur. The ratio of males and females who suffered femoral shaft fractures was. Conventional teaching indicates that the femoral neck fracture potentially is the more problematic part of this pattern. Because the femur is so strong, it usually takes a lot of force to break it. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone.
Femoral shaft is the elongated, straight part of the femur and any breakage or fracture along the length of this shaft is known as femoral shaft fracture. Treatment depends on the age, fracture pattern, and weight of the patient. Reduce the fracture to it pre fracture alignment and apply a spica cast. Femur shaft fractures broken thighbone orthoinfo aaos. Femoral shaft fractures musculoskeletal medicine for. To promote fracture healing, static fixation is sometimes changed to a dynamic one wiss et al. Fracture shaft femur free download as powerpoint presentation. Most femoral shaft fractures require surgery to heal. Do you want to use the redesigned ao sr like an app. Healing of 56 segmental femoral shaft fractures after locked nailing. Femoral shaft fractures occur most commonly in young men and elderly women following highenergy trauma and lowenergy falls, respectively.
The limb will be shortened and rotated outward see photo 1. Very young children are sometimes treated with a cast. Usually occur in young men after high energy trauma and elderly women even after a low energy fall. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture.
Fractures of the femoral shaft are mostly the result of highenergy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. Femoral shaft fractures reportedly occur at a rate of approximately 20100,000 children in the usa, representing 1. Femur shaft fractures broken thighbone duke ahn, m. Arriving at the algorithm must be an aaos member to view aaos now and jaaos articles. Ipsilateral femoral neck and shaft fractures, proximal fe moral nail, reduction, cephalomedullary nail background combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. Subsequent imaging in the trauma bay demonstrates a bifrontal cerebral contusion, an l4 burst fracture, multiple rib fractures, an lc1 type pelvic ring injury, a femoral shaft fracture, and an open ipsilateral tibial shaft fracture.
Femoral shaft fracture is a common traumatic musculoskeletal injures in pediatric population. Femur shaft fracture treatment boston medical center. Typical femur fractures will present in distinct ways. Pediatric femoral fractures may involve the proximal femur, the femoral shaft, or the distal femur. Research article injuries associated with femoral shaft. However, alho 1,2 thought that the femoral shaft fracture was the main determining factor of the patients overall outcome. There are ipsilateral knee injuries in 20%40% of patients and ipsilateral tibial fractures in approximately 10% of cases. Breaking your femur can make daily tasks more difficult because its one.
Locking plate fixation in pediatric femur fracture. The combination of ipsilateral femoral shaft and tibial shaft fractures, producing a floating knee, signals a high risk of multisystem injury in the patient. Fracture of shaft of femur 1 fracture of shaft of femur 2. These fractures often involve the cartilage surface of the knee joint and are most commonly seen in people with severe osteoporosis or those who have previously undergone total knee replacement surgery. Femoral shaft fracture, also known as broken thighbone, is the breakage of the shaft of the femur or thighbone.
What is femoral shaft fracturetypescausestreatment. Seventy percent of femoral fractures involve the shaft. Epidemiology, fracture patterns, nonunions, and fatigue fractures a clinical study sari salminen academic dissertation to be presented with the permission of. The femur is the strongest and longest bone in our body. Pediatric femoral shaft fractures are one of the most common peditric orthopaedic fractures and are the most common reason for pediatric orthopaedic hospitalization. There will be a bulge at the point of the break pointing to its location i.
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