femoral shaft fracture Taiz University , faculty of medicine and health sciences By Dr : Mulk Wadee

1. Femoral Shaft Fractures

2. Long tubular bone,
anterior bowed
forward and has
oblique course from
the neck to distal end.
ANATOMY

3. MUSCLE
Muscle of the thigh are arranged in three
Compartments
1-anterior compartment of thigh
Contains the sartorius and the four large
quadriceps
2-medial compartment of thigh
(gracilis ,pectineus, adductor longus, adductor
brevis, adductor magnus, and obturator externus)

4. 3-posterior compartment of thigh
contain three large muscle termed the ‘”hamstring”
It is surrounded by massive musculature ,which
provide the femur with excellent blood supply

7. Femoral Shaft Fractures
* Common injury due to major violent trauma
* 1 femur fracture/ 10,000 people
* More common in people < 25 yo or >65 yo
* Femur fracture leads to reduced activity for
107 days, the average length of hospital stay
is 25 days
* Motor vehicle, motorcycle, auto-pedestrian,
aircraft, and gunshot wound accidents are
most frequent causes

9. CLASSIFICATIONFEMUR FRACTURE
* Type 0 - No commination
*Type 1 - Insignificant butterfly fragment
with transverse or short oblique fracture
*Type 2 - Large butterfly of less than 50%
of the bony width, > 50% of cortex intact
*Type 3 - Larger butterfly leaving less than
50% of the cortex in contact
*Type 4 - Segmental commination
Inquest and Hansen 66A,
1984
Axial and
rotational
stability

11. SYMPTOMS
Vague, diffuse pain or ache, and sometimes
tenderness and swelling in the thigh or groin.
Bleeding and bruising in the thigh (uncommon).
Weakness and inability to bear weight on the
injured leg.
Paleness and deformity (less common).

12. ‫ء‬
x-ray
well confirm the diagnosis and establish the
sites ,line ,extent and displacement

15. MANAGEMENT

19. SUPINE - BETTER FOR MULTIPLY INJURED
PATIENTS, TOUGH STARTING POINT
LATERAL - EASIER PIRIFORMIS FOSSA
STARTING POINT, DIFFICULT SET UP, ?
ROTATION
WITHOUT A FRACTURE TABLE, LENGTH,
DISTAL LOCK FIRST AND SLAP NAIL

20. Supine with bolster under torso
Manual traction and rotation

21. 1-GENERAL
blood loss, shock
,imbolism, and acut
respiratory distress
are common in
hight-energy injuries
COMPLICATION

22. COMPLICATION
2-VASCULAR INJURY
3-THROMBOEMBOLISM
4-INFECTION
5-DELAY UNION AND NON-UNION
6-JOINT STIFFNESS