Femur Fracture is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

Fractures classified according to:
  • Location:
    • Proximal 3rd (subtrochanteric region)
    • Middle 3rd
    • Distal 3rd (distal metaphyseal–diaphyseal junction)
  • Geometry:
    • Spiral
    • Transverse
    • Oblique
    • Segmental
  • Extent of soft tissue injury:
    • Open
    • Closed
  • There are 2 commonly accepted classification systems of femoral fractures: The AO/OTA and the Winquist and Hansen.
  • Degree of comminution: Winquist and Hansen classification:
    • Grade I: Fracture with small fragment <25% width of femoral shaft; stable lengthwise and rotationally
    • Grade II: Fracture with 25–50% width of femoral shaft; stable lengthwise; may or may not have rotational stability
    • Grade III: Fracture with >50% width of femoral shaft; unstable lengthwise and rotationally
    • Grade IV: Circumferential loss of cortex; unstable lengthwise and rotationally

Etiology

  • Usually requires major, high-energy trauma
  • Patients are mostly young adults with high-energy injuries (motor vehicle accidents [MVAs], gunshot wounds [GSWs], falls):
    • Spiral fractures with falls from height
  • Consider pathologic fracture if minor mechanism
  • Can occasionally be due to stress fracture from repetitive activity
  • Complications include compartment syndrome, fat embolism, adult respiratory distress syndrome (ARDS), hemorrhage.

Geriatric Considerations
  • Atypical femur fractures have been associated with use of bisphosphonate medications.


Pediatric Considerations
  • 70% of femoral fractures in children <3 yr old are the result of nonaccidental trauma (NAT).
  • Spiral fractures of the femur strongly suggest NAT.

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Femur Fracture ID - 307032 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307032/all/Femur_Fracture ER -