A femoral fracture is considered a severe injury to the musculoskeletal system and requires complex treatment. Depending on the location of the violation of integrity, several types of injury are distinguished. There will be severe pain, decreased mobility, deformation and shortening of the limb, large blood loss (with an open fracture). The diagnosis is clarified using radiography. If necessary, examinations inside the joint are prescribed MRI. Treatment involves fixing the fragments for further proper fusion.
General information
Femur fractures occur from a direct impact or fall on the leg. Such injuries have many complications. Injuries occur at any level of the fragment, therefore, in medicine, they are classified as fractures:
- trochanteric and femoral neck (upper bone);
- diaphyseal (bone body);
- distal (lower part).
These injuries differ in the mechanism of exposure, symptoms, treatment methods, and prognosis for recovery.
First aid
A fracture of such a large bone can be fatal, so emergency treatment should be provided immediately. If the vessels are damaged with an open fracture, a tourniquet must be applied above the wound to stop bleeding. It is important to remember that this must be done for only 2 hours, otherwise tissue necrosis will occur. A note indicating the time is placed under the clothes. If there is no paper, write on the victim's skin. It is better not to leave information on clothes, in the hospital they can take them off.
A broken leg must be immobilized, this will prevent the displacement of fragments, increased bleeding. A splint or straight board is applied to the entire leg from the lower back to the foot from the outside and inside of the lower limb. At the same time, the foot should not hang. The victim is placed on a stretcher and transported to the hospital. To relieve pain, an anesthetic drug is given (Ibuprofen, Nurofen, Analgin, Paracetamol).
Trochanteric and femoral neck fractures
The thigh bone is tubular. In its upper part is the head, which enters the hollow of the pelvic bones, forms the hip joint. Below the head there is a thin septum - the neck. It connects to the body at an angle. In these places there are protrusions - a small and large spit. Impact damage often occurs in these areas.
Fracture causes
Upper femur injuries are usually seen in old age. This is facilitated by osteoporosis and low muscle tone. In the female body, the angle between the neck and the body of the bone is sharper than in men, and the neck itself is thinner. For this reason, injuries are more common.
Trochanteric fractures occur due to injuries in accidents, falls, emergencies, during sports. With age, hip injuries can occur even with stumbling, a sharp transfer of the weight of the body to one leg.
© rob3000 - stock.adobe.com
Damage symptoms
A femur fracture is always accompanied by excruciating pain, which can only be relieved by drugs. Injuries to the neck and trochanteric protuberances manifest themselves in different ways.
Injury to the femoral neck is accompanied by moderate pain in the pelvic and groin areas. When moving, the intensity of discomfort increases sharply. Feeling the fracture zone does not cause much discomfort, muffled pain is felt. There is swelling of the tissues, but no bruising.
A trochanteric fracture is characterized by less limb mobility. The pains are sharp, when palpation becomes unbearable, hemorrhages are visible at the site of the injury, edema is more pronounced.
In case of damage to the upper part of the femur, there is a rotation of the affected leg to the outside, its shortening and "sticky heel syndrome" - the inability to lift in the supine position.
Treatment tactics
The femoral neck is not covered by the periosteum, so it grows together poorly. The blood supply is obstructed, the fragments become covered with dense connective tissue over time. The higher the damage is, the worse the fusion prognosis will be. Disability is often the result of treatment without surgery.
The trochanteric protuberances are well supplied with blood, and callus forms rapidly in trauma. Damage in this part heals without surgery with good treatment. Complications can occur with multiple displaced fragments.
The tactics of therapy are selected by the traumatologist, depending on the degree of damage and the age of the patient. For intra-articular fractures, surgery is desirable. Contraindications to this method are chronic diseases and old age. Prolonged bed rest can lead to complications in the form of bedsores, pneumonia, and thromboembolism. For this reason, it is necessary to provide the patient with mobility in combination with immobilization of the injured limb. Bone fixation with a trilobate nail or bone autoplasty is performed.
For trochanteric fractures, skeletal traction is recommended for two months. Next, a plaster cast is applied. It will be possible to step on the injured limb in 4 months. The operation for such injuries can shorten the treatment period. During surgery, fixation is performed with a three-blade nail, screws and plates. After 6 weeks, full load on the leg is allowed.
Diaphyseal fractures
Damage to the body of the femur is accompanied by large blood loss and painful shock.
Causes of injury
Bone damage occurs as a result of impact, fall, bending, twisting. People of young and middle age are more often affected. A variety of fragments appear, which pull the muscles attached to them in all directions. This causes numerous displacements.
Damage symptoms
The main complaints of victims of a fracture of the femur:
- unbearable pain at the site of injury;
- edema;
- deformation of the leg;
- abnormal mobility;
- blood loss;
- shortening of the limb;
- traumatic shock.
© praisaeng - stock.adobe.com
The main directions of treatment
To prevent the development of traumatic shock, the victim is prescribed pain relievers and sedatives. To recover from blood loss, a blood transfusion is performed. Depending on the injury, it is necessary to connect the parts of the bone and remove the existing fragments. For this, methods of external fixation, hardware traction, and surgery are used.
If there are severe chronic diseases, infection of an open wound, poor health of the patient, then instead of an operation, skeletal traction is prescribed for 6-12 weeks. Then a plaster cast is applied for 4 months. In this case, the hip and knee joints remain motionless for a long time, which negatively affects their condition. The operation allows you to increase the patient's mobility faster and avoid complications due to forced prolonged immobility. Surgical intervention is carried out in the absence of contraindications, the patient's normal state of health. This uses rods, plates, pins.
© staras - stock.adobe.com
Distal fractures
The femur at the bottom has an expansion and forms two condyles - internal, external. Their surfaces are in contact with the tibia, kneecap, forming a knee joint.
Condylar fractures occur due to a fall or impact on the knee joint, sometimes accompanied by displacement of fragments. Elderly people suffer more. There is a possibility of damage to one or both of the condyles. Displacement of fragments upward and to the side is characteristic. Usually, blood is poured into the articular bag during injury.
Trauma symptoms
Typical signs of damage to the lower femur:
- acute knee pain;
- limitation of movement in the limb;
- swelling of the knee joint;
- deflection of the lower leg outward (with a fracture of the external condyle) or inward (with damage to the internal condyle).
Features of the treatment of distal injuries
After anesthesia, a puncture of the damaged joint is performed. The trapped blood is pumped out, the drug is injected. If there was no displacement, then a plaster cast is applied from the ankles to the groin area for 1-2 months, depending on the severity of the injury. If there are fragments, they are compared, only then they are fixed with plaster. When it is impossible to correctly fold the parts of the bone, an operation is performed, the pieces are fixed with screws. Skeletal traction is used if necessary.
After treatment, a recovery course is carried out. Physiotherapy, therapeutic massage, good nutrition, special exercises help to quickly restore the mobility of the diseased limb.
A hip fracture is a serious injury, especially in old age. The doctor chooses the methods of treatment depending on the patient's health and the degree of damage. Rehabilitation will be long, you need to start it in the hospital and continue at home.
