Femoral Shaft Fracture Flashcards
What is the femur supplied by
Branches of the Profunda femoris artery
In which situations are femoral shaft fractures most commonly seen in
High energy trauma
Fragility fractures - old age
Pathological fractures - eg metabolic bone disease
Bisphosphonate related fractures
What are the clinical features of the femoral shaft fractures
Pain in the thigh, knee
Unable to weight bear
Obvious deformity
What is the winquist and Hansen classification
Used to classify the degree of communition to the femoral shaft
What is type 0 fracture on the WH classification
No communition
What is type 1 fracture on the WH classification
Insignificant communition
What is type 2 fracture on the WH classification
Greater than 50% cortical contact
What is type 3 fracture on the WH classification
Less than 50% cortical communition
What is type 4 fracture on the WH classification
Segmental fracture with no contact between proximal and distal
What are the differential diagnosis
ankle, tibial shaft, tibial plateau, pelvis, and spinal fractures.
what are the investigations needed
Routine bloods urgent - ( make sure you have a coag and group and save )
Imaging
AP and lateral X-ray of entire femur including hip and knee
What is the non surgical management of femoral fractures
A-E management
Adequate pain relief
Regional block if needed
Immediate reduction needed and immobilisation
Traction splinting
Long leg cast
What is the surgical management of femoral shaft fractures
Most treated with antegrade intramedullary nail
Some may need external fixation with subsequent intra-medullary nail insertion ( for multiple fragments )
what are the complications of femoral shaft fracture
Pudendal nerve injury ( 10%)
Mal union, delayed union, non union
Infection
Fat embolism
