Understanding Femoral Fractures

What are femoral fractures, and how are they treated?

A femoral fracture is a serious injury that affects the femur, the strongest bone in your body. In this article, you’ll learn what femoral fractures are, the different types, and how they’re treated to help patients recover mobility and reduce pain.

At OrthoNeuro, our board-certified orthopedic hip specialists offer expert diagnosis and personalized treatment plans for femoral fractures at multiple locations throughout Columbus, Ohio. If you or a loved one has experienced a femur injury, contact us today to schedule an appointment.

There are different types of femoral fractures according to the severity and where they occur. They are also classified by how the fracture breaks.

About Femoral Fractures

Most femur fractures are caused by high-energy trauma, such as car accidents or falls from significant heights. However, in older adults with weaker bones, even a low-impact fall can result in a serious fracture of the femur. Because the femur is involved in weight-bearing and movement, any fracture can significantly affect mobility and daily function.

Complications can arise depending on the severity of the injury. In cases of extreme swelling or internal bleeding, acute compartment syndrome may develop, putting pressure on nerve and muscle cells and restricting blood flow. Additionally, there’s a rare but serious risk where bone marrow enters the bloodstream, potentially leading to fat embolism syndrome.

Femur fractures cause severe pain. Patients often report knee pain and soreness in the hip or thigh area, depending on the location of the fracture. The fracture can sometimes result in the fractured leg being shorter than the uninjured leg.

Femoral fractures often require surgical fixation in addition to immobilization to heal. Treatment plans may include topical pain medications to help manage discomfort during the recovery period.

There are different types of femoral fractures, categorized by their severity and location. They are also classified by how the fracture breaks.

At OrthoNeuro in Columbus, Ohio, our orthopedic surgeons offer a range of treatment options for femur fractures, tailored to the specific location of the fracture. We also offer rehabilitation programs through physical therapy to help you recover and become active again.

What Are the Types of Femur Fractures?

There are four types of femoral fractures according to the severity:

Type 1: Stress Fractures

Stress fractures are small cracks in the bone. They are a common overuse injury, especially in high-impact sports. They typically occur in weight-bearing bones, such as the femur.

As the muscles get tired, they take less strain from the shocks in these sports and other activities. As a result, the bone absorbs more of the impact, and it can crack over time.

Type 2: Severe Impaction Fractures

Impaction fractures occur when the two ends of the bone are forced toward each other by some trauma. The bone then breaks into multiple pieces and is forced to interlock with each other.

Type 3: Partial Fractures

A partial fracture occurs when the bone breaks open but does not break all the way through. It is also known as an incomplete fracture.

When the bone does break all the way through, it is referred to as a complete fracture. This could happen in one or more places.

Type 4: Complete Displaced Fractures

A displaced fracture refers to the position of the bone after the break. If the bone breaks away from the proper position, it is referred to as a displaced fracture.

So, a fracture can be described as either a complete or an incomplete displacement fracture.

Femoral Fractures According to Location

Femoral fractures can occur in four different places:

Femoral Head Fractures

These types of fractures are usually stress fractures that cause pain in the hip joint. They can occur more frequently in long-distance runners and others who participate in repetitive strenuous activities.

The Pipkin classification is as follows:

Type I: Femoral head fracture inferior to the fovea centralis
Type II: Fracture extended superior to the fovea centralis
Type III: Any femoral head fracture with an associated femoral neck fracture
Type IV: Any femoral head fracture with an associated acetabular fracture

Femoral Neck Fractures

Femoral neck fractures are the most common location of hip fractures.

Femoral Shaft Fractures

Most femoral shaft fractures occur after a high-energy impact or in elderly women after a low-energy fall. The bone can fracture in different ways.

Types of Femoral Shaft Fractures

Femur fractures can vary significantly depending on the amount and direction of force that causes the break. At the fracture site, the pieces of bone may align properly, resulting in a stable fracture, or they may shift out of place, leading to a displaced fracture.

In addition, the skin and tissue around the injury determine whether the break is a closed fracture (the skin remains intact) or an open or compound fracture (where bone fragments puncture the skin). Open fractures often cause severe soft tissue damage, can tear surrounding blood vessels, and carry a high risk of bone infection. These injuries often require immediate intervention to prevent serious complications.

Doctors describe fractures using standardized classification systems based on:

The location along the femoral shaft (proximal, middle, or distal third)
The pattern of the break (crosswise, angled, or twisting)
The extent of damage to the skin, muscles, and surrounding structures

The most common types of femoral shaft fractures include:

Transverse fracture: A clean, straight break horizontally across the femur shaft.
Oblique fracture: A diagonal break across the bone, often caused by an angled force.
Spiral fracture: A fracture line encircles the shaft, typically resulting from a twisting injury to the injured leg.
Comminuted fracture: The bone shatters into three or more broken bone fragments, making treatment more complex and the fracture heals more slowly.
Open fracture: Also called a compound fracture, where either bone fragments stick out or an external wound reaches down to the fractured femur. These injuries often damage surrounding muscles, ligaments, and blood vessels, and greatly increase the risk of bone infection.

Understanding the specific type of fracture is crucial for effectively treating femoral shaft fractures, whether it involves skeletal traction, screws and metal plates, or other surgical methods to stabilize the bone and facilitate recovery.

Femoral Condyle Fractures

The fracture occurs on the femur close to the knee. It can sometimes happen after an ACL reconstruction.

How Femoral Fractures Are Treated

Nearly all cases of femoral fractures require surgical treatment. However, there are many different ways that a surgeon may use to fix your fracture back in place for it to heal, such as:

External Fixation

Screws or pins are inserted into the bone and connected to a bar outside the leg to hold the broken bones together. This method is a quick and effective way to temporarily fix the bones in position.

Intramedullary Nailing

A custom-sized titanium rod is inserted through the bone canal of the femur, holding the bone in its proper place. Screws are inserted at either end to hold the rod in place while the bone heals.

Internal Fixation

This method is often used when intramedullary nailing is not possible, such as when the fracture extends into the hip or knee joint. Plates and screws are used to hold the bone fragments in place until they heal.

Make an Appointment with an OrthoNeuro Hip Specialist Today!

If you have or suspect a femoral fracture, schedule an appointment with one of our board-certified orthopedic hip specialists at one of our convenient locations throughout Greater Columbus. We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you. Contact us today!

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IF YOU HAVE SEVERE OR PERSISTENT HIP PAIN THAT INTERFERES WITH YOUR LIFE, CALL ORTHONEURO OR SCHEDULE A CONSULTATION ONLINE TODAY. OUR ORTHOPEDIC SURGEONS PROVIDE STATE-OF-THE-ART DIAGNOSIS AND PERSONALIZED TREATMENT.