Transverse femur fracture managed with an im nail is not the same injury as a midshaft femur fracture managed with the same device, and the rehabilitation protocol must be individualized based on the injury and bony stability. The strength and size of the femur means that under typical circumstances, a large force or extensive trauma is needed in order to result in a fracture. Once a fracture does occur, this same protective musculature usually is the cause of displacement, which commonly occurs with femoral shaft fractures. After general emergency care guidelines using a welldesigned properly applied. Apr 01, 2006 the purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluationbased, immediateweightbearing approach to rehabilitation.
Kim kaczor ms, mary clyde pierce md, in child abuse and neglect, 2011. Do you want to use the redesigned ao sr like an app. The treatment of these fractures can vary greatly depending on the age of the patient and the fracture pattern. If the patient is to be transferred to another hospital, the leg should be immobilised in a thomas type splint if available or a backslab. Hg and an unstable pelvic fracture, mast should be used. What is femoral shaft fracturetypescausestreatment. The pattern of the fracture, such as the fracture of the femoral shaft can occur in different directions, e. Older adults can fracture their femur from a fall because their bones tend to be weaker. Request pdf on jan 1, 2017, sanjeev bhatia and others published midshaft clavicle fracture open reduction and internal fixation. In this type of fracture, the break is a straight horizontal line.
In this type of femoral shaft fracture, there is an angled line across the shaft. Surgical therapy is focused on immediate fracture stabilisation. This type of fracture is known as an open or compound fracture and these types of fractures commonly are associated with increased damage to the surrounding. Tibiafibula full leg, air splint, vacuum splint, cardboard, or an appropriate commercially. Use the information below to gain a better understanding of your injury and what can be done to maximise your recovery. All 45 tests resulted in midshaft femur fractures with comminuted wedge and oblique fractures as the most common fracture patterns. Midshaft clavicle fracture open reduction and internal fixation.
Midshaft femur oblique fracture and intraarticular distal. This information will guide you through the next 6 weeks of your rehabilitation. Femoral shaft fractures should be put into skin traction 10% of body weight to help with pain management. Midshaft fracture of clavicle sternocleidomastoid muscle weight of arm. A femoral fracture is a bone fracture that involves the femur. The most common fracture type of the femoral shaft is a noncomminuted simple ao type a, most of which, in traumatic fractures, are purely transverse and located in the middle third of the femur. This rare benign bone tumor was treated with an acute en bloc excision and femoral shortening over an intramedullary nail. Biomechanical in vitro testing was performed to determine whether two modified osteosyntheses with end caps or a third nail could. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. Your digital gateway to expertise, education, and innovation. Full leg splints are not sufficient to splint midshaft femur fractures.
Postsurgical condition right femur intramedullary rod fixation. Mar 26, 2008 the open femur fracture was irrigated with a liter of isotonic sodium chloride solution. He is treated with retrograde femoral nailing, and postoperatively is noted to have 30 degrees of internal rotation of the operative extremity, when compared with. Elastic stable intramedullary nailing esin is accepted widely for treatment of diaphyseal femur fractures in children. Midshaft clavicle fracture open reduction and internal. We report a rare case of desmoplastic fibroma df of the midshaft femur presenting as a pathological fracture. Osteolytic or osteoblastic metastasis can lead to pain and immobilisation due to a pathologic femur fracture. Oct 10, 2018 an example of an isolated, short, oblique midshaft femur fracture.
The purpose of this case report is to describe the outcome of a patient following fixation of a midshaft femur fracture and an evaluationbased, immediateweightbearing approach to rehabilitation. Pdf early rehabilitation following surgical fixation of a. The pectoralis major muscle inserts on the proximal shaft while the deltoid muscle attaches to the midshaft. From 2007 to 2012, forty adult patients with an acute nonpathological fracture of the midshaft of the clavicle with an initial shortening of 15 mm or more or displaced fractures or fractures with impending skin penetration fig 1 were treated surgically at our centre. The association between bisphosphonates and femur fracture is discussed separately see risks of bisphosphonate therapy in patients with osteoporosis, section on atypical femur fractures and the use of bisphosphonates in postmenopausal women with osteoporosis, section on overview of approach.
Dec 07, 2017 the fracture location, as the femur is divided into 3 parts. The femur is the anatomical name given to the long bone of the thigh figure 1. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia and kneecap, forming the knee joint. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. The reaction loads were used to develop the injury criteria given that they represent the inertially compensated bending strength of the femur that is more appropriate for dummy load cell application. Lateral and posterior dynamic bending of the midshaft.
Femur shaft fractures broken thighbone orthoinfo aaos. Femoral shaft fracture in children not yet walking must raise suspicion for nonaccidental trauma. Its shape conforms to the anatomic contour of a specific area of bone, and therefore separate implants are available for the left and. The pectoralis major muscle inserts on the proximal shaft while the deltoid muscle attaches to. What is femoral shaft fracturetypescausestreatmenthealing. It can break when a child experiences a sudden forceful impact. Fractures of the femoral diaphysis can be lifethreatening on account of an open wound, fat embolism, adult respiratory distress syndrome ards zalavras et. Md the most effective emergency care for a fractured femur is the use of a mechanical type traction splint such as developed by hare and described herein.
The nonviable skin edges of the open fracture sites were debrided sharply. The long, straight part of the femur thighbone is called the femoral shaft. The thin soft tissue coverage on the anterior aspect of the distal end of the femur is a frequent problem. The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. Among athletes, the most prevalent type of femoral injury is midshaft stress fracture, which accounts for 20% of all stress fractures in this population. Figure 1 relevant anatomy for a femoral shaft fracture. In this type of fracture of the femoral shaft, the bone is fractured such that the fragments of the bone stick out or pierce through the skin or there is a wound that penetrates down to the fractured bone. For intramedullary fixation of proximal femur fractures. Complications and injuries associated with midshaft femur fractures in the adult can be lifethreatening and may include. Pdf early rehabilitation following surgical fixation of. Pediatric femoral shaft fractures are one of the most common peditric orthopaedic fractures and are the most common reason for pediatric orthopaedic hospitalization. Femoral shaft fractures often result from high energy forces associated with possible multiple system injuries bucholz and jones 1991.
Children that sustain femur fractures prior to walking age should be screened for nonaccidental. Because of this and its protective surrounding muscle, the femoral shaft requires a large amount of force to fracture. Jul 31, 2018 a broken femur is usually caused by a severe accident. Once union of the acute shortening had been achieved, further surgery was undertaken to lengthen the femur with the use of intramedullary skeletal kinetic.
At 3 years after fracture, our patient had achieved equal leg lengths, had normal knee function, and was disease free. Because magnetic resonance imaging mri was readily available in our facility and neither the patient nor the. Spiral fractures that are related to low energy trauma situate in the middle third of. The patient was a 28yearold male manual laborer whose left femur was fractured in a headon motor vehicle accident. In this type of femoral shaft fracture, the femur is fractured in three or more pieces. A fractured femur is a breakage in the thigh bone femur, the longest, strongest and heaviest bone in the human body. Surgical therapy is focused on immediate fracture stabilisation offering a durable and solid fixation. Identification and management of 2 femoral shaft stress. Df resulting in pathological fracture of the midshaft femur is extremely rare and has not been reported to occur in the femoral diaphysis. Femur traction splint refer to section on traction splinting warning.
Femur midshaft fracture pulse wound free 30day trial. The liss less invasive stabilization system plate was designed for fracture fixation in the metaphyseal and diaphyseal regions, initially for the distal femur and later for the proximal tibia,, fig 25. Early rehabilitation following surgical fixation of a femoral. Identification and management of 2 femoral shaft stress injuries marc d. We discuss a midshaft humerus fracture using simple language and useful pictures to help everyone understand this topic. For the purposes of fracture classification, the lesser tuberosity marks the boundary between the proximal humerus and the midshaft. Usually, the number of fragments of the bone corresponds with the degree of force required to break the femur. The most common types of femoral shaft fractures include.
Femoral fractures in children are classified following the alphanumeric system of the aopaeg 32. The patient was taken to the operating room for debridement of the fracture and skeletal stabilization. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. Identification and management of 2 femoral shaft stress injuries. The femur is the largest and strongest bone and has a good blood supply. Thighbone femur fractures in children orthoinfo aaos. Femur midshaft fracture free download as powerpoint presentation. Fractures of the femoral shaft often result from high energy forces such as motor vehicle collisions. The femur is the longest, strongest, and heaviest tubular bone in the human body and one of the principal load bearing bones in the lower extremity. However, complication rates of 10 to 50 % are described due to shortening or axial deviation, especially in older or heavier children. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. Radiographs did not reveal a lucent fracture line, but did show a subtle periosteal reaction along the medial aspect of the midshaft of the right femur, consistent with a stress reaction figure 2.
Displaced femoral fractures are uncommon without trauma and are typically associated with highimpact sports such as equestrian, motorized, or highspeed sports. Improving stability of elastic stable intramedullary. A total of 45 experiments were performed on human cadaver femurs using a dynamic threepoint drop test setup. Both model and available experimental data substantiated this timedependent peak fracture load phenomenon for impact durations below 20 ms. Lets take a quick look a midshaft humerus fracture, aka a broken arm. Symptoms from a femoral shaft stress fracture can be vague and mimic those of other. Neurovascular injuries are mostly observed in the type 3 distal femur complex trauma.
Midshaft femur fracture injury condition right distal third oblique femur shaft fracture with displacement. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone. A femoral shaft fracture is a condition characterized by a break in the shaft of the femur thigh bone. Injury condition right distal third oblique femur shaft fracture with displacement. Bilateral midshaft femoral fractures in an adolescent. Find, read and cite all the research you need on researchgate. In adolescents, motor vehicle accidents either in cars, bicycles, or as a pedestrian are responsible for the vast majority of femoral shaft fractures. We will explain how a midshaft humerus fracture is diagnosed, different ways to treat a broken arm, and what are the outcomes after a broken arm, and the. The thighbone femur is the largest and strongest bone in the body. However the tfn system also offers a lag screw fixation using an 11. Another genesis of femur fractures is carcinogenic.
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