Femoral Shaft Fracture
What is it: A fracture through the diaphysis of the femur. Typically result from high-energy trauma. Pathologic fractures secondary to ostoepenia are less common but might result from less substantial trauma.
How does it present: Patients report severe pain in the thigh and may have an obvious deformity. Patients are usually unable to move the affected limb and cannot bear weight.
Common exam findings: Inspect for deformity, swelling and skin lacerations causing an open injury. A thorough musculoskeletal examination may avoid overlooking other associated injuries. A neurovascular exam should be documented. Pain with the Femoral Log Roll Test and Heel Strike Test may help identify possible femur fractures.
Tests and treatment: AP and lateral radiographs of the femur will diagnose most fractures but especially in high energy trauma, remember to evaluated for other associated injuries. Surgical treatment is indicated for the vast majority of patients. Temporary splinting and skeletal traction may be useful aid for patients awaiting surgical evaluation.