Types of femoral bone fractures

Neck fracture

Inter-trochanteric

Sub-trochanteric #

Shaft fractures

F. Neck fracture

GeneralFacts

Causes Treatment Complication

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Garden classification

incomplete

Impacted in valgus

complete # with partial D.

complete with full displacement

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Garden classification

Classification According to

site of # subcapital

Transcervical

basicervical

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Garden classification

Classification According to

site of #

subcapital Transcervical basicervical

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Garden classification

Classification According to

site of #

Missing F neck

Fractures ?

Femoral neck # can be missed in 4 groups

stress # in Elderly Patients

Non-displaced #

painless ( silent ) #

multiple #s

X

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Garden classification

Classification According to

site of #

Missing F neck

Fractures ?

Radiologic investigation

X-ray

MRI Bone scan

If normal but clinical suspicion of a hip # remains high

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Elderly simple falls

Young high-energy

injuries

falls into greater

trochanter

[as fall from height or RTA

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Elderly Young

All patients require surgery if fit for an operation

Internal F. with lag multiple 3-4 screws or pins placed in

parallel fashion

Better to have prosthetic replacement

F. Neck fracture

GeneralFacts

Causes Treatment Complication

If young

with

Displaced #

Emergent surgery[close or open reduction

+ internal Fixation]

To prevent

Osteonecrosis

F. Neck fracture

GeneralFacts

Causes Treatment Complication

Nonunion Osteonecrosis Healing

inhibition

↑ with displacement

& older

↑ with displacement & intracapsular

hematoma

by Synovial fluids or Angiogenic-

inhibiting factors

F. Shaft fracture

Causes Treatment Complication

F. Shaft fracture

Causes Treatment Complication

If Elderly

Always Suspect pathological fracture until proven otherwise

Young high-energy

injuries

F. Shaft fracture

Causes ComplicationTreatment

Treatment if with neck #

or vascular injury

Open reduction + plating

if child + have anesthesia problems + inability to

do IF

Traction & bracing

Method of choice

Intramedullary nailingas controls rotation & stabilize distal third #

if multiple or severe open injuries , severe Bn loss

or adolescents

External fixation

Treatment

• Method of choice• Intramedullary nailing as controls rotation & stabilize

distal third #• if with neck # or vascular injury• Open reduction + plating • if child + have anesthesia problems + inability to do IF• Traction & bracing • if multiple or severe open injuries , severe Bn loss or

adolescents• External fixation

Method of choice

Intramedullary nailingas controls rotation & stabilize distal third #

F. Shaft fracture

Causes ComplicationTreatment

1

if with neck # or VI

Open reduction + plating

F. Shaft fracture

Causes ComplicationTreatment

2

if child + have anesthesia problems + inability to do IF

Traction & bracing

F. Shaft fracture

Causes ComplicationTreatment

3

if multiple or severe open injuries , severe Bn loss or adolescents

External fixation

F. Shaft fracture

Causes ComplicationTreatment

4

F. Shaft fracture

Causes ComplicationTreatment

1.Vascular injury.2.Thromboembolism3.Infection 4.Delayed union & non-union5.Malunion 6.Joint Stiffness