Surgery to repair a femur fracture is meant to reposition the broken portion of bone back where it belongs, and keep it from shifting out of place until it has time to heal properly.
Your femur, also known as your thighbone, is the single longest and strongest bone in your body. The femur makes up the majority of your upper leg, extending from your hip joint to your knee joint.
Because the femur is so strong, it takes a significant amount of force to break it. High-energy collisions, such as severe falls and motor vehicle crashes are the most commonly seen causes.
Like with most bones, your femur can experience a large variety of fracture types. Femur fractures are first classified by their exact position on the bone. Distal fractures occur near the knee joint, middle fractures occur along the bone’s shaft, and proximal fractures occur near the hip joint. Fractures are then classified based on the breakage pattern, and whether or not skin and muscle tissue has been damaged by the injury. In more serious injuries, the fractured portion of the femur can break the skin (open fracture), or even break into more than two pieces (comminuted fracture). Fracture classification is very important to surgeons as treatment difficulty varies depending on the type of break. Fractures that involve portions of other joints and tissue, or in which the broken portion of the bone is displaced from its original position are typically more difficult to repair.
Femur fractures cause immediate and severe pain, limit your ability to put weight onto the injured leg, and often give the leg a deformed appearance. Non-surgical treatments are only utilized in rare situations involving young children. Almost all femur fractures require surgical repair to provide the best opportunity for a return to normal function.
To help your doctor diagnose your specific fracture, it’s important that they know the ins and outs of your injury. Prior to surgery your doctor will conduct multiple medical history and physical examinations, as well as X-rays and CT scans. If skin around your fracture is not lacerated, your surgeon will wait until you’re stable before operating. In the event of an open fracture, surgery is required within 8 hours of the injury. Prior to realigning the fracture, exposed tissue and bone must be thoroughly cleaned and antibiotics are provided to help avoid infection.
Multiple methods might be utilized by your surgeon in repairing a femur fracture, depending on the severity and the type of fracture being operated on. The most common method used by orthopedic surgeons is known as intramedullary nailing. During this procedure, a long metal rod is inserted into the marrow canal of the femur. From the inside, this rod extends through the full length of the bone, including the fractured portion. Then, using titanium screws, the rod is screwed into position at each far end of the femur. This keeps the metal rod and the connected bone held into position until the fracture can properly heal. Other surgical procedures typically involve an incision that allows direct access to the broken portion of bone. After repositioning the fracture, metal plates and screws are used to hold the bone in a correct position while it heals.
Most doctors will encourage early leg motion and weight-bearing activity during recovery. Physical therapy programs help rebuild strength in damaged muscle tissue and can drastically improve mobility. Most femur fractures heal completely in 6-8 months.