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Chapter: Orthopaedics

Orthopaedics: Femur

1. Femoral Diaphysis Fracture 2. Distal Femoral Fracture



Femoral Diaphysis Fracture



·                 high energy trauma (MVA, fall from height, gunshot wound)

·                 in children, can result from low energy trauma (spiral fracture)


Clinical Features

·                 shortened, externally rotated leg (if fracture displaced)

·                 inability to weight-bear

·                 often open injury, always a Gustilo III



·                 AP pelvis, AP/lateral hip, femur, knee


Specific Complications

·                 hemorrhage requiring transfusion

·                 fat embolism leading to ARDS

·                 extensive soft tissue damage

·                 ipsilateral hip dislocation/fracture

·                 nerve injury



·                 stabilize patient

·                 immobilize leg

·                 ORIF with intramedullary nail, external fixator, or plate and screws within 24 hours

·                 early mobilization and strengthening


Distal Femoral Fracture



·                 direct high energy force or axial loading

·                 three types (Figure 37)


Clinical Features

·                 direct high energy force or axial loading

·                 extreme pain

·                 knee effusion (hemarthrosis)

·                 shortened, externally rotated leg ifdisplaced



·                 ORIF

·                 early mobilization and strengthening


Complications (see General Fracture Complications)

·                 femoral artery tear

·                 nerve injury

·                 eDensl.ve soft tissue injury

·                 angulation deformities


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