Femoral Fractures
Top Contributors - Margaux Jacobs, Nupur Smit Shah, Kim Jackson, Vanderpooten Willem, Lucinda hampton, Admin, Vidya Acharya, Jentel Van De Gucht, Rachael Lowe, Alex Palmer, Daphne Jackson, Margaux Jacobs, Jason Coldwell, Aminat Abolade, Lauren Lopez, WikiSysop, 127.0.0.1, Evan Thomas and Alexandra Stead
Introduction
The femur is the largest and strongest bone in the body. Due to its strength it requires a significant force to break it. However, certain medical conditions that weaken the bone make it more vulnerable to fracture, so called pathological fractures. For example: osteoporosis; malignancy; infection.[1] It is very serious injury and it is more common among elderly population due to falls. As per World health organisation, femoral fractures leads to long term problems like disability, chronic pain and mental health issues. This fracture happens due to significant external force and the recovery process is long and complex. Elderly population often suffers from this fracture due to reduced bone mineral density and balance ability. Other factors include age, gender, nutritional status, dietary habits, previous fractures, sports injuries, medications, occupational hazards and socioeconomic conditions.[2][3]
.jpeg)
Location
There are different types of femoral fractures according where they occur, namely:
- Femoral Head Fractures: often seen in the elderly osteoporotic population where the cortical bone is weak and so is the trabecular system. It occurs spontaneously or due to low-energy trauma. In the younger population, this fracture is rare and occurs due to high-energy trauma, usually associated with hip dislocations.[4][5]
- Femoral Neck Fractures: one of the most frequent fractures presenting to the emergency department and orthopaedic trauma teams.
- Femoral Shaft Fractures: more common in men after a high-energy impact or in elderly women after a low-energy fall.[6] They can be described as follows: Type I - Spiral or transverse (most common) Type II – Comminuted Type III - Open
- Distal femoral fracture: involve the femoral condyles and the metaphyseal region, often the resulting from high energy trauma e.g. motor vehicle accidents or a fall from a height. In the elderly, they may occur as an accident at home e.g. fall.[3]
Signs and Symptoms of Distal Femur fracture
- Severe Pain and swelling on weightbearing and unable to move the affected part.
- Tender on palpation
- Bruising
- Potential visible deformity
- Unable to bear the weight and affected limb may appear shorter.
- Instability[3]
Types of Fracture
There are 4 types of fracture:
- Femoral stress fracture
- Severe impaction fractures: the bone breaks into multiple fragments, which are driven into each other. It is a closed fracture that occurs when pressure is applied to both ends of the bone, causing it to split into two fragments that jam into each other.
- Partial fracture: incomplete break of a bone. This type of fracture refers to the way the bone breaks. In an incomplete fracture, the bone cracks but doesn’t break all the way through. In contrast, there is a complete fracture, where the bone snaps into two or more parts.
- Completed displaced fracture: breaks into two or more pieces and is no longer correctly aligned. Displacement of fractures is defined in terms of the abnormal position of the distal fracture fragment in relation to the proximal bone.
Complications
- Cognitive alterations
- Postoperative delirium
- Deep Vein Thrombosis
- Heart failure /myocardial ischemia/ respiratory failure
- Hospital acquired pneumonia
- Urinary retention/ Urtinart tract infection
- Vitamin D insufficiency
- Pressure scars[7]
References
- ↑ Fischer H, Maleitzke T, Eder C, Ahmad S, Stöckle U, Braun KF. Management of proximal femur fractures in the elderly: current concepts and treatment options. European journal of medical research. 2021 Aug 4;26(1):86.
- ↑ Fu F, Liu B, Pu H, Wang Y, Zhang P, Wei S, Gu H, Zhang Q, Ye H. Global Trends in the Incidence and Primary Causes of Femoral Fractures, Excluding Femoral Neck Fractures: A Global Epidemiological Study. Risk Management and Healthcare Policy. 2025 Dec 31:117-29.
- ↑ 3.0 3.1 3.2 Singh R, Ambade R, Landge S, Goyal S, Goel S. Comprehensive review on distal femur fractures: from epidemiology to treatment strategies. Cureus. 2024 Apr 9;16(4).
- ↑ Ahn TR, Yoon YC, Kim HS, Kim K, Lee JH. Association between pelvic bone computed tomography-derived body composition and patient outcomes in older adults with proximal femur fracture. Korean journal of radiology. 2023 Apr 25;24(5):434.
- ↑ Menger MM, Braun BJ, Herath SC, Küper MA, Rollmann MF, Histing T. Fractures of the femoral head: a narrative review. EFORT open reviews. 2021 Nov 19;6(11):1122-31.
- ↑ Mercer's Textbook of Orthopaedics and Trauma Tenth edition edited by Suresh Sivananthan, Eugene Sherry, Patrick Warnke, Mark D Miller
- ↑ Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: A review. World journal of orthopedics. 2014 Sep 18;5(4):402.