Mid-shaft femur fracture: Difference between revisions

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==Evaluation==
==Evaluation==
===Workup===
*Radiography
*Radiography
**Obtain films of knee, femur, and hip for operative planning and to assess for other injury
**Obtain films of knee, femur, and hip for operative planning and to assess for other injury
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**PT/PTT
**PT/PTT
**Type & Screen
**Type & Screen
===Diagnosis===
*Typically via plain films


==Management==
==Management==

Revision as of 13:29, 11 January 2020

Includes all subtrochanteric femur fractures

Background

Location of femur fractures
  • Occurs with severe trauma or in association with pathologic bone
    • Blood loss can be substantial (average loss = 1L)

Clinical Features

  • Clinical presentation is similar to intertrochanteric fracture
    • Affected leg is shortened and externally rotated

Differential Diagnosis

Femur Fracture Types

Proximal

Shaft

Evaluation

Workup

  • Radiography
    • Obtain films of knee, femur, and hip for operative planning and to assess for other injury
  • Pre-op labs
    • CBC
    • Chem 7
    • PT/PTT
    • Type & Screen

Diagnosis

  • Typically via plain films

Management

General Fracture Management

Immobilization

  • Consider traction splint
    • Little evidence to support its use[1]
    • Theoretical benefit of traction splinting is reduction in bleeding and improved pain
    • Sager and Hare splints are commonly used by EMS providers
    • Buck's traction used by ortho

Disposition

  • Admit
    • Typically requires ORIF

See Also

External Links

Wheelers' Textbook - Femoral Shaft Fracture

References

  1. Agrawal Y, Karwa J, Shah N, et al. Traction splint: to use or not to use. J Perioper Pract. 2009; 19(9):295-298.