femur is the strongest bone in the human body, requiring considerable force to break. Motor vehicle accidents are the leading cause of broken femurs due to the violent movement the body endures during a collision.
Fractured femurs require surgical intervention, presenting a number of potential risks for patients, including infection, blood clots, and permanent disability. In addition to considerable pain and discomfort, a fractured femur injury may result in loss of mobility and income.
What Is a Broken Femur Injury?
The femur connects the hip to the knee. A broken femur is a serious injury that necessitates immediate medical intervention to realign the bones of the leg and preserve damaged muscles, tendons, and ligaments. The most common causes of broken femur injuries include:
- Car accidents
- Motorcycle accidents
- Pedestrian accidents
- Falls from heights
- Gunshot wounds
- Sports Injuries
- Child abuse
Broken femurs are more common in people over age 65, who are already at an increased risk for fractures. Medical professionals use X-rays and CT scans to diagnose a broken femur and visualize the bone. The majority of femur fractures require surgery within 24-48 hours of the injury.
Types of Femur Fractures
If your broken femur was caused by a motor vehicle accident, it can be helpful for your doctor to know how fast the car was traveling at the time of the crash, whether you were the driver or the passenger, if you were wearing a seatbelt, and whether or not the airbags deployed. This information can aid your healthcare team in identifying the type of fracture you have and the best treatment options. Common femur fracture types include:
Transverse fracture
A simple fracture, with the break cleanly across the femur in a horizontal line.
Spiral fracture
Fractures that spiral around the femur and are the result of the thigh bone being twisted during injury. Spiral fractures can be a sign of abuse in infants and very small children.
Oblique fracture
A break that angles across the femur.
Comminuted fracture
Sometimes referred to as a shattered femur, there are three or more broken pieces of fractured bone involved.
Compound Fracture
A compound fracture, also known as an open fracture, is the most serious type of fracture, carries the highest risk for complications, and takes the longest to heal. It occurs when pieces of broken bone pierce through the skin, and typically includes more severe damage to the muscles, tendons, and ligaments.
What Are the Risks Associated With a Broken Femur?
In addition to the primary risks associated with any fracture, broken femurs carry special risks because they almost always require surgical intervention. A broken femur can result in major physical impairment and cause threats to life and limb when not addressed promptly. Complications from a broken femur can include:
- Bruising
- Swelling
- Infection
- Severe pain
- Malalignment of bones
- Muscle and tendon irritation from surgical hardware
- Permanent shortening or malformation of the limb
- Nerve damage and loss of sensation
- Broken hip secondary to femur fracture
- Damage to the knee joint
- Nonunion (bones that fail to heal) or delayed union
- Acute respiratory distress syndrome
- Injury to internal organs
- Severed blood vessels
- Hemorrhage
- Blood clots
- Complications from anesthesia
- Uncontrollable pain
- Pain medication dependence
- Shock
- Amputation
Some complications are particularly dangerous for patients with a broken femur. Acute Compartment Syndrome (ACS) can occur following surgery to repair the bone. Pressure in the affected leg builds up to dangerous levels, cutting off the blood flow. Nerves and muscles unable to receive necessary oxygen begin to die. ACS can lead to permanent muscle and nerve damage, necrosis, and amputation if left untreated.
Fat embolism syndrome is the result of fat and bone marrow entering the bloodstream and traveling to the lungs. This condition causes shortness of breath and eventual loss of consciousness.
Despite precautions taken, like cleaning and disinfecting skin and bones during surgery, patients are at an increased risk for infections of the bone itself. Bone infections require multiple surgeries and long-term antibiotic treatment. If left untreated, there is a risk for amputation.
What Is the Treatment for a Broken Femur?
A broken femur is typically treated with a combination of surgery, physical therapy, and pain-controlling medications. It can take four to six months to heal completely. Your healthcare provider may use a temporary splint to immobilize the femur and manage your pain until surgery. In certain situations, surgery must be delayed while the health team stabilizes other injuries or conditions you may have.
Surgery
Two types of surgery are common in femur repair:
- Intramedullary nailing requires the surgeon to make an incision at the hip or knee joint. They line up the broken pieces of the femur and insert a titanium rod into the canal of the femur, passing across the fracture to keep the leg in position and stabilize it.
- External fixation surgery uses metal bolts to stabilize the bone. The bolts are temporarily secured to a frame outside of the body while the bone heals.
Following surgery, you won’t be able to bear weight on your injured leg. You may be placed in traction for a period of time with weights attached to a frame connected to your leg. Traction keeps the femur straight, ensures that the bones stay aligned, and maintains the natural length of the leg.
Physical Therapy
A physical therapist will help you learn how to use the leg again and condition the muscles, tendons, and ligaments to function properly around the fractured bone.
Pain Medication
There is significant pain that comes with suffering a broken femur. Your doctor will prescribe pain medication to help you be more comfortable. Be aware of opioid medications that come with a risk of dependence.
What Is the Long-Term Prognosis for a Broken Femur?
After you leave the hospital, you will need help for the first couple of weeks while you recover. If you live alone, this could require you to hire a home health aide or have a friend or family member assist you. You may also need to modify your home by installing grab bars in the bathroom and showers.
In order to keep the femur elevated and prevent swelling, you will sleep flat on your back, which many patients find uncomfortable. Even after you recover, a broken femur injury can cause pain years after the fracture heals due to nerve damage, scar tissue, and arthritis.
The economic cost of treating a broken femur, along with the pain and suffering you will endure, is significant. If your injury was caused by the negligence of another, you may be eligible to seek damages to cover your medical and home modification expenses. Skilled personal injury attorneys can explain your options and help you move forward.
Sources:
Cleveland Clinic- Broken Femur
American Academy of Orthopaedic Surgeons
Mayo Clinic
University of Texas
National Heart, Lung, and Blood Institute
National Library of Medicine- Acute Compartment Syndrome
International Journal of Critical Illness & Injury Science
