II. Pathophysiology

  1. High energy injury (often in young adults)
    1. Motor vehicle accident
    2. Pedestrian accident
    3. Fall from height

III. Diagnosis

  1. See Hip Fracture
  2. Distal to first 5 cm of femoral shaft
    1. Below Subtrochanteric Fracture
  3. Descriptive Classification
    1. Proximal or distal location
    2. Transverse or oblique angle
    3. Comminuted (common)

IV. Management

  1. See Femur Fracture (includes Hare Traction Splint)
  2. Immobilize hip and knee
  3. Evaluate for associated injuries (see pitfalls below)
  4. Closely manage fluid status
    1. Initial Resuscitation with isotonic crystalloid
    2. Average blood loss from Femur Fracture: 1.2 units
    3. Type and Cross for 2 Units pRBC
    4. Continually reassess hemodynamic status
  5. Open reduction and internal fixation
    1. Intramedullary rods

V. Complications

  1. Significant blood loss and hemodynamic instability
  2. Peroneal artery and peroneal nerve injury
    1. Associated with distal Femur Fracture

VI. Pitfalls: Associated injuries (common)

  1. Hip Fracture including Femoral Neck Fracture
  2. Supracondylar Femur Fracture
  3. Patella Fracture
  4. Knee ligament injury

VII. References

  1. Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60
  2. Russell (2002) Orthop Clin North Am 33(1):127-42 [PubMed]

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Ontology: Fracture of shaft of femur (C0272753)

Concepts Injury or Poisoning (T037)
ICD10 S72.3
SnomedCT 157234004, 208593004, 54441004
English fracture of shaft of femur (diagnosis), fracture of shaft of femur, Femur shaft fracture, femoral fracture shaft, femoral fractures shaft, femur shaft fracture, Fracture;femur;shaft, femoral shaft fracture, Fracture of shaft of femur, Fracture of shaft of femur (disorder), fracture; femur, shaft
German Fraktur des Femurschaftes, Femurschaftfraktur
Korean 넓적다리뼈 몸통의 골절
Spanish Fractura del cuerpo del fémur, fractura de la diáfisis del fémur, fractura de la diáfisis del fémur (trastorno), fractura de diáfisis de fémur, fractura de diáfisis de fémur (trastorno)
Portuguese Fractura da diáfise do fémur
French Fracture de la tige du fémur
Italian Frattura del corpo del femore
Czech Zlomenina diafýzy femuru
Dutch fractuur in femurschacht, fractuur; femur, schacht, Femurschachtfractuur
Japanese 大腿骨骨幹部骨折, ダイタイコツコツカンブコッセツ
Hungarian Femur diaphysis törés