Femur shaft fracture

Question 1

> 8cm from knee joint

Answer 1

Medullary Nail
Biologically better
Early weightbearing

Question 2

Advantages of reaming (3) ?

Answer 2

Reamed to :

• increase implant size
• increase contact through isthmus lengthening
• micro bone transplant (less pseudarthrosis)

Question 3

Disadvantages of reaming (3) ?

Answer 3

• heat
• emboly through higher pressure
• higher blood loss

Question 4

Retrograde for (2) ?

Answer 4

• more distal fracture

- joined tibia fracture

Question 5

Retrograde makes more

Answer 5

Knee pain

Question 6

Vascular supply of diaphysis

Answer 6

porfunda femoris branch

distal to proximal direction

Question 7

Anterior compartment muscles

Answer 7

Quadriceps
Sartorius
Pectineus
Terminal Iliopsoas

Question 8

Anterior compartment nerve

Answer 8

Femoral Nerve

Question 9

Anterior compartment artery

Answer 9

Profunda Femoris

Question 10

Medial (adductor) compartment muscles

Answer 10

Adductor longus
Adductor brevis
Adductor longus
Adductor magnus

Question 11

Medial (adductor) compartment nerve

Answer 11

Obturator nerve

Question 12

Medial (adductor) compartment artery

Answer 12

Internal iliac artery

Question 13

Posterior compartment muscles

Answer 13

semimembranous
semitendinous
biceps femoris

Distally contains proximal attachments of the gastrocnemius and popliteal muscles.

Question 14

Posterior compartment nerve

Answer 14

tibial portion of the sciatic nerve

Question 15

Posterior compartment arteries

Answer 15

anastomoses from the profunda femoris
gluteal arteries (proximally)
popliteal artery (distally)

Question 16

Femoral shaft fracture (bleeding)

Answer 16

up to 750 ml
Thomas Splinting (WW1)

Question 17

AO Classification (32X)

Answer 17

A spiral
B Wedge
C Multifragmentary

Question 18

AO Classification (32AX)

Answer 18

32A1 spiraloid
32A2 oblique ≥30°
32A3 transverse <30°
a proximal 1/3
b middle 1/3
c distal 1/3

Question 19

AO Classification (32BX)

Answer 19

32B2 intact wedge
32B3 fragmentary wedge
a proximal 1/3
b middle 1/3
c distal 1/3

Question 20

AO Classification (32CX)

Answer 20

32C2 intact segmental fracture
32C3 fragmentary segmental fracture
i Proximal diaphyseal-metaphyseal 
j Pure diaphyseal 
k Distal diaphyseal-metaphyseal

Question 21

Standard versus Reco Nail

Answer 21

Reco nail for proximal femoral fractures or associated femoral neck fractures.

Question 22

Femoral shaft plating (disadvantages)

Answer 22

biologic: disrupts periosteum and fracture hematoma
biomechanic: plate is load bearing, nai is load sharing.

Question 23

Femoral shaft plating (indications)

Answer 23

vascular injury

significant comminution