Femoral fracture

For fractures to the femoral head, neck and trochanteric region, see hip fracture.
Femoral fracture
Classification and external resources
ICD-10 S72
AO 31-A1 - 33-C3
MeSH 68005264

A femoral fracture is a bone fracture that involves the femur.

Femoral shaft fractures

Femoral shaft fractures can be classified with the Winquist and Hansen classification, which is based on the amount of comminution:[1]

Distal femur fractures

Fractures of the inferior or distal femur may be complicated by separation of the condyles, resulting in misalignment of the articular surfaces of the knee joint, or by hemorrhage from the large popliteal artery that runs directly on the posterior surface of the bone. This fracture compromises the blood supply to the leg (an occurrence that should always be considered in knee fractures or dislocations).[2]

Treatment

A 2015 Cochrane review found that available evidence for treatment options of distal femur fractures is insufficient to inform clinical practice and that there is a priority for a high quality trial to be undertaken.[3]

Available evidence suggests that treatment depends on the part of the femur that is fractured. Traction may be useful for femoral shaft fractures because it counteracts the force of the muscle pulling the two separated parts together, and thus may decrease bleeding and pain.[4] Traction should not be used in femoral neck fractures or when there is any other trauma to the leg or pelvis.[5][6]

References

  1. Page 612 in: Title Surgical treatment of orthopaedic trauma. Authors: James P. Stannard, Andrew H. Schmidt, Philip J. Kregor. Publisher: Thieme, 2007. ISBN 1-58890-307-9, ISBN 978-1-58890-307-5
  2. Keith L. Moore, Arthur F. Dalley, Anne M.R. Agur. p527 of Clinical Oriented Anatomy 7th edition ISBN 978-1-4511-8447-1
  3. Griffin, XL; Parsons, N; Zbaeda, MM; McArthur, J (13 August 2015). "Interventions for treating fractures of the distal femur in adults.". The Cochrane database of systematic reviews. 8: CD010606. doi:10.1002/14651858.CD010606.pub2. PMID 26270891.
  4. Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. p. 9. ISBN 0-07-148480-9.
  5. AAOS. "29". In Andrew N. Pollak MD. FAAOS. Emergency Care and Transport of the Sick and Injured (Print) (10 ed.). Sudbury, Massachusetts: Jones and Bartlett. pp. 1025–1031. ISBN 978-1-4496-3056-0.
  6. Marx, John A. (2014). Rosen's emergency medicine : concepts and clinical practice (Eighth edition. ed.). London: Elsevier Health Sciences. p. 680. ISBN 9781455749874.
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