Femur Fracture

A femur fracture is the medical term for a broken femur. The femur is your thigh bone. It’s the longest, strongest bone in your body.

You’ll probably need surgery to repair your bone and physical therapy to help you regain your strength and ability to move. It usually takes several months to recover.

Types of femur fractures

Healthcare providers sometimes classify fractures by the break’s shape or pattern. Examples include:

• Buckle (impacted) fracture
• Comminuted fracture
• Oblique fracture
• Spiral fracture
• Transverse fracture

Your provider might diagnose your fracture as open or closed. Open fractures happen when your bone breaks through your skin. Providers also call these compound fractures.

Displaced or non-displaced are other words your provider will use to describe a fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke.

Symptoms of a femur fracture

Femur fracture symptoms include:

• Severe pain in your thigh and leg
• Swelling
• Tenderness
• Not being able to move or use your leg
• Bruising or discoloration
• A bump (deformity) that’s not usually on your leg

You’ll probably know if you have a femur fracture. It usually happens after a severe injury. Don’t try to stand or walk on your leg if you think your femur is broken. Call 911 or your local emergency services number.

Femur fracture causes

Because your femur is so strong, it usually takes a severe trauma to fracture it. Causes can include:

• Car accidents
• Falls from a height, like off a roof or ladder
• Gunshots
• Sports injuries

Risk factors

Anyone can break a femur. But you may be more likely to experience this injury if you:

• Play contact sports
• Are over 65, especially if you have an increased fall risk
• Have a health condition that affects your bone density

People with osteoporosis or osteopenia are much more likely to experience broken bones, especially from falls. Osteoporosis weakens your bones. This makes you more susceptible to sudden and unexpected fractures.

Femur fracture complications

The injuries that cause fractured femurs can damage other parts of your leg, too, including your:

• Muscles
• Nerves
• Tendons and ligaments
• Blood vessels

The pieces of your broken femur can also damage tissue when they’re pushed out of place.

How doctors diagnose this condition

A healthcare provider will diagnose a femur fracture with a physical exam and some imaging tests. Providers in the emergency room might diagnose the fracture if you’re taken to the ER after a trauma, like a car accident.

Your provider will use at least one of these tests to take pictures of your femur and the area around it:

• X-ray
• MRI
• CT scan

How are fractured femurs treated?

You’ll almost always need surgery to repair a broken femur. Because the femur is so vital to your ability to stand, walk and move, it’s important to make sure it heals correctly.

Open reduction and internal fixation (ORIF) is the most common surgery to treat a femur fracture. A surgeon will realign your bone and set it in the correct position. They'll usually insert a metal rod through the center of your femur. This will support it while it heals. They may insert other fasteners like plates, screws or wires into your femur if it’s broken into more than two pieces, or if the fracture is near your hip joint.

Healthcare providers may put your leg in traction before surgery. This is a temporary way to keep your femur as stable as possible before you can have surgery. You may need traction if you have other, more severe or life-threatening injuries that need to be treated first, or if it’s not safe for you to have surgery right away. There are two types of traction:

• Weighted traction splints: Healthcare providers will put your leg in a frame with straps that go around your ankle, shin and up your leg. The frame will put gentle pressure on your femur to hold it safely in place.
• Skeletal traction: A surgeon will insert a temporary pin into your femur or shin bone. Then, they’ll attach the pin to weights and pulleys on a device outside your body. This will hold your leg stable and keep your femur straight.

You might also need external fixation. Your surgeon may do this if you need ORIF but it’s not safe for you to have it right away. They’ll put screws in your bone on either side of the fracture, inside your body. Then, they’ll connect the screws to a brace or bracket around the bone, outside your body.

Possible surgery complications

Fracture surgery complications are rare but can include:

• Malunion
• Nonunion
• Bone infections (more common in open fractures)
• Compartment syndrome in the muscles around your broken femur
• Blood clots

When should I call my healthcare provider?

Call your provider if you have any of these symptoms after surgery:

• Shortness of breath or chest pain when you breathe
• Skin discoloration or increasing pain around your surgery site
• Drainage or pus leaking from your surgery site
• Swelling in one of your legs
• Sudden, sharp pain in your calf
• A fever higher than 101 degrees Fahrenheit (38.3 degrees Celsius)
• Pain that doesn’t get better after taking medication

Broken femur recovery time

It usually takes four to six months to recover from surgery for a fractured femur. And it might take a while before you can resume all your usual activities. It can take up to a year to recover fully from a broken femur.

Your surgery care team will tell you what to expect. You’ll need at least a few months of physical therapy to help you regain your strength.

Ask your provider when you can resume physical activities. You’ll need to move your leg to prevent stiffness as you heal. But don’t start playing sports, working out or using your leg for intense physical activities before your provider says it’s safe.