Fractured Femur

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Introduction

What is a fractured femur?

A fractured femur is a breakage in the thigh bone (femur), the longest, strongest and heaviest bone in the human body. The strength and size of the femur means that under typical circumstances, a large force or extensive trauma is needed in order to result in a fracture. Motor vehicle accidents and falls are examples of common accidents that result in a fractured femur. Conversely, femur fractures that occur after low-energy trauma suggest the presence of some type of underlying bone condition. A fractured femur in a child may be a sign of child abuse.

Symptoms of a fractured femur can include severe pain, bleeding, deformity of the leg, tissue swelling, and being unable to move your leg. Blood loss can be severe and may lead to hypovolemic shock. In some cases, bone fragments may protrude from the skin. Fractures of the femur are commonly associated with traumatic circumstances that may result in injuries to other areas of the body as well.

Treatment of a broken femur involves restoration of the normal anatomical position of the bone fragments, referred to as reduction of the fracture. The exact methods used for treatment depend upon the individual situation and must take into account the extent and nature of the break as well as the treatment of any other injuries. Both surgical and nonsurgical treatment options may be considered.

A fractured femur is an emergency situation. Seek immediate medical care (call 911) for serious symptoms, such as trauma followed by the inability to move your leg, severe pain, swelling, bleeding, or deformity.

Symptoms

What are the symptoms of a fractured femur?

Symptoms of a fractured femur are primarily localized to the area of the thigh. If other injuries or severe bleeding are associated with the fracture, these conditions may also produce symptoms, some of which may be life threatening.

Common symptoms of a fractured femur

Typically, a fractured femur results in intense pain, deformity, and inability to move the leg. Common symptoms include:

Serious symptoms that might indicate a life-threatening condition

A fractured femur is an emergency that can in some cases be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Confusion or loss of consciousness for even a brief moment
  • Heavy or uncontrollable bleeding
  • Inability to move the leg
  • Low blood pressure (hypotension)
  • Protruding fragments of bone through the skin
  • Severe pain

Causes

What causes a fractured femur?

Accidents are the most common cause of fractured femur. A relatively strong force is required to break this sturdy bone in otherwise healthy individuals, so motor vehicle accidents and high impact falls are among the most common causes. The fracture can occur anywhere along the bone. Most ‘hip fractures’ are actually fractures of the neck of the femur. Certain conditions, such as osteoporosis or cancer that has invaded the bone marrow, can make involved bones more susceptible to breakage. Traumatic injuries are rarely an isolated event and often occur with other injuries – external or internal.

Even with appropriate treatment, healing of a fractured femur can take up to six months.

What are the risk factors for a fractured femur?

A number of factors increase the risk of a fractured femur. Not all people with risk factors will get fractured femur. Risk factors for fractured femur include:

  • Age over 65
  • Deconditioning (loss of muscle mass, muscle weakness)
  • Driving while intoxicated or under the influence of drugs
  • Frailty (general weakness, fatigue, loss of muscle mass and strength)
  • Metabolic bone disease
  • Metastatic (widespread) cancer
  • Not wearing seat belts while driving or riding in a car
  • Osteoporosis
  • Participating in extreme or contact sports
  • Severe kidney disease
  • Tendency to fall

Reducing your risk of a fractured femur

You may be able to lower your risk of a fractured femur by:

  • Driving safely using appropriate restraints
  • Improved nutrition
  • Safeguarding your living environment to eliminate risk of accidental falls
  • Taking appropriate precautions when participating in contact or extreme sports
  • Treating osteoporosis

Treatments

How is a fractured femur treated?

Treatments for a fractured femur are based upon realignment of the fragments of the broken bone so that healing can take place. In some cases, dependent upon the location and extent of the fracture as well as the presence of associated injuries, surgical implantation of plates, rods, or screws may be necessary to help hold the bone fragments in place. Casting and traction are also common treatments.

Pain control and infection control may require the administration of pain-relieving medications and antibiotics.

Treatments for a fractured femur

A number of both surgical and nonsurgical treatment options are available. Medications may also be used to help relieve your symptoms. Treatments for a fractured femur include:

  • Antibiotics, particularly if the skin is broken and the possibility for infection is high
  • Bed rest
  • Casting of the affected limb
  • Pain control medications
  • Surgically implanted fixation devices such as plates, rods or screws
  • Traction

What are the potential complications of a fractured femur?

Complications of a fractured femur can be serious, even life threatening in some cases. If the fracture has broken through the skin, the possibility for infection is increased. Severe injuries with profuse bleeding may lead to circulatory collapse or shock. Poor healing of the fracture can result in deformity or disfigurement, or the need for further surgery.

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of fractured femur include:

  • Anemia
  • Chronic pain or discomfort
  • Deformity
  • Infection
  • Long-term disability
  • Numbness
  • Paralysis
  • Shock
  • Venous thrombosis
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 28
  1. Femur fracture repair - discharge. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000166.htm
  2. Thighbone (femur) fracture. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00364
  3. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy.Philadelphia: Saunders, 2013
  4. Bucholz RW, Heckman JD, Court-Brown CH, et al. (Eds). Rockwood and Green's Fractures in Adults, 6th Ed., Philadelphia: Lippincott Williams & Wilkins, 2005
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