Femur Fracture

The thigh bone (femur) is the strongest and longest bone in the body. A femur fracture is a break or cracks to the thigh bone. 

Short crack femur fractures usually do not need surgery. Most femur fractures result from high-energy injuries, and the patients are represented with prominent swelling, tenderness, deformity, and pain in the affected thigh. The femoral shaft is the longest part of the femur. If there is a break anywhere in the femoral shaft, it is known as femoral shaft fracture.

In young people, femoral shaft fractures are frequently due to some type of high-intensity collision. The most common causes of femoral shaft fracture are:

1. Accidents due to motor vehicles and falls from heights or ladders due to loss of balance
2. Wounds due to gunshots in battlefields
3. In elderly people, weak bones might lead to falls while standing, which can cause femoral shaft fracture. 
4. Conditions, like “osteoporosis” (in which bone becomes weak and brittle) or “osteosarcoma” (a type of bone cancer that begins in the cell) that has invaded the bone marrow, can make involved bones more prone to breakage.

Numerous factors are involved in increasing the risk of “femur fracture”; however, it is not necessary that all people with risk factors will get fractured femurs.  Factors involved are:

1. After 65 years of age, bone density deteriorates and decreases over time, causing weak and brittle bones, which increases the risk of fracture.
2. Deconditioning (loss of muscle mass and muscle weakness)
3. Loss of muscle mass, fatigue, and strength
4. Metabolic bone disease
5. Metastatic (widespread) cancer
6. Participating in extreme or contact sports
7. Severe kidney diseases
8. Tendency to fall
9. Travelling in a car without the seat belt on
10. Driving while you are drunk or under the influence of drugs

1. The most common signs of a fractured or broken bone are bruising discolouration, and pain.
2. Swelling: When a bone breaks, it's common for the area to begin to swell.
3. Swelling or bruising over a bone
4. Deformity of the leg
5. Inability to move the affected leg
6. Muscle spasm
7. Numbness or tingling
8. Severe pain
9. Discolouration
10. Dislocation

1. It is important that your doctor knows the specifics of how you hurt your leg.
2. It is also important for you to tell your doctor if you have any other underlying conditions, such as high BP, diabetes, asthma, or allergies.
3. Your doctor will ask you if you consume any tobacco products or any other medications. 
4. After knowing about your injury and medical history, your doctor will do a thorough examination.              
5. An obvious deformity of thigh and leg (an unusual angle, twisting or shortening of the leg).
6. Breaks in the skin
7. Bruises
8. Presence of any bony pieces that may be pushing on the skin.

Investigations: 

1. X-Rays:
   1. These are the most common way to evaluate a fracture, as these provide clear images of the bone.
   2. X-Ray pictures represent whether your bone is intact or broken.
2. Computerised Tomography (CT):
   1. If your doctor still needs more information after reviewing X-Rays, they may order a CT scan.
   2. A CT scan informs the doctor more about the severity of your fracture.

Some effective bone fracture therapies include:

1. Fracture management: Including close reduction (bone alignment through manipulation or traction), immobilisation (using a splint or cast), and rehabilitation (physical therapy).
2. Physical therapy: You will regain strength and your affected area will start functioning normally.
3. Medications are often prescribed for short-term pain relief. These include non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioids, and topical pain medication.

1. A femur fracture might impact your ability to live independently.
2. Most people who have femur fractures aren’t able to regain the ability to live freely.
3. If a femur fracture keeps you immobile for a longer time, the complications may include:
   1. Blood clots in your legs
   2. Bedsores
   3. Further loss of muscle mass, which increases your risk of falls and injuries

Disease progression

1. Type 0: A small butterfly fragment that is less than 25 % of the bone or no comminution 
2. Type I: A small butterfly fragment is less than 25 % of the bone
3. Type II: A butterfly fragment is 50 % or less of the width of the bone
4. Type III: Comminution with a large butterfly fragment is greater than 50 % of the width
5. Type IV: There is severe comminution of an entire segment of bone (segmental comminution)