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id="toc-Classification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Classification"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Classification</span> </div> </a> <ul id="toc-Classification-sublist" class="vector-toc-list"> <li id="toc-Femoral_shaft_fractures" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Femoral_shaft_fractures"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3.1</span> <span>Femoral shaft fractures</span> </div> </a> <ul id="toc-Femoral_shaft_fractures-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Distal_femur_fractures" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Distal_femur_fractures"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3.2</span> <span>Distal femur fractures</span> </div> </a> <ul id="toc-Distal_femur_fractures-sublist" class="vector-toc-list"> </ul> </li> </ul> 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class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Broken femur, at shaft or distally</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For fractures to the femoral head, neck and trochanteric region, see <a href="/wiki/Hip_fracture" title="Hip fracture">hip fracture</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Femoral fracture</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Medical_X-Ray_imaging_IYN05_nevit.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Medical_X-Ray_imaging_IYN05_nevit.jpg/300px-Medical_X-Ray_imaging_IYN05_nevit.jpg" decoding="async" width="300" height="366" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Medical_X-Ray_imaging_IYN05_nevit.jpg/450px-Medical_X-Ray_imaging_IYN05_nevit.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Medical_X-Ray_imaging_IYN05_nevit.jpg/600px-Medical_X-Ray_imaging_IYN05_nevit.jpg 2x" data-file-width="2035" data-file-height="2486" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">X-ray image of a femoral shaft fracture</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data">Orthopedic</td></tr></tbody></table> <p>A <b>femoral fracture</b> is a <a href="/wiki/Bone_fracture" title="Bone fracture">bone fracture</a> that involves the <a href="/wiki/Femur" title="Femur">femur</a>. They are typically sustained in high-impact trauma, such as <a href="/wiki/Traffic_collision" title="Traffic collision">car crashes</a>, due to the large amount of force needed to break the bone. Fractures of the <a href="/wiki/Diaphysis" title="Diaphysis">diaphysis</a>, or middle of the femur, are managed differently from those at the head, neck, and <a href="/wiki/Trochanter" title="Trochanter">trochanter</a>; those are conventionally called <a href="/wiki/Hip_fracture" title="Hip fracture">hip fractures</a> (because they involve the <a href="/wiki/Hip_joint" class="mw-redirect" title="Hip joint">hip joint</a> region). Thus, mentions of femoral fracture in <a href="/wiki/Medicine" title="Medicine">medicine</a> usually refer implicitly to femoral fractures at the shaft or distally. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Fractures are commonly obvious, since femoral fractures are often caused by high energy trauma.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Signs of fracture include swelling, deformity, and shortening of the leg.<sup id="cite_ref-:0_2-0" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Extensive soft-tissue injury, bleeding, and shock are common.<sup id="cite_ref-:1_3-0" class="reference"><a href="#cite_note-:1-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The most common symptom is severe pain, which prevents movement of the leg.<sup id="cite_ref-:2_4-0" class="reference"><a href="#cite_note-:2-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=2" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Common_fracture_locations_of_femur.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Common_fracture_locations_of_femur.jpg/220px-Common_fracture_locations_of_femur.jpg" decoding="async" width="220" height="129" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Common_fracture_locations_of_femur.jpg/330px-Common_fracture_locations_of_femur.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bc/Common_fracture_locations_of_femur.jpg/440px-Common_fracture_locations_of_femur.jpg 2x" data-file-width="896" data-file-height="525" /></a><figcaption>Common locations of fracture of femur</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Physical_exam">Physical exam</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=3" title="Edit section: Physical exam"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Femoral shaft fractures occur during extensive trauma, and they can act as distracting injuries, whereby the observer accidentally overlooks other injuries, preventing a thorough exam of the complete body.<sup id="cite_ref-:2_4-1" class="reference"><a href="#cite_note-:2-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> For example, the ligaments and meniscus of the ipsilateral (same side) knee are also commonly injured.<sup id="cite_ref-:0_2-1" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_3-1" class="reference"><a href="#cite_note-:1-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Radiography">Radiography</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=4" title="Edit section: Radiography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Anterior-posterior (AP) and lateral radiographs are typically obtained.<sup id="cite_ref-:2_4-2" class="reference"><a href="#cite_note-:2-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> In order to rule out other injuries, hip, pelvis, and knee radiographs are also obtained.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The hip radiograph is of particular importance, because femoral neck fractures can lead to <a href="/wiki/Avascular_necrosis" title="Avascular necrosis">osteonecrosis</a> of the femoral head.<sup id="cite_ref-:2_4-3" class="reference"><a href="#cite_note-:2-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=5" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Structure_of_a_Long_Bone.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Structure_of_a_Long_Bone.png/220px-Structure_of_a_Long_Bone.png" decoding="async" width="220" height="330" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Structure_of_a_Long_Bone.png/330px-Structure_of_a_Long_Bone.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Structure_of_a_Long_Bone.png/440px-Structure_of_a_Long_Bone.png 2x" data-file-width="1000" data-file-height="1500" /></a><figcaption>The diaphysis is the midshaft of the femur</figcaption></figure> <p>The fracture may be classed as <i>open</i>, which occurs when the bone fragments protrude through the skin, or there is an overlying wound that penetrates to the bone. These types of fracture cause more damage to the surrounding tissue, are less likely to heal properly, and are at much greater risk of infection.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Femoral_shaft_fractures">Femoral shaft fractures</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=6" title="Edit section: Femoral shaft fractures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Femoral_shaft" class="mw-redirect" title="Femoral shaft">Femoral shaft</a> fractures can be classified with the <a href="/wiki/Winquist_and_Hansen_classification" title="Winquist and Hansen classification">Winquist and Hansen classification</a>, which is based on the amount of <a href="/wiki/Comminution" title="Comminution">comminution</a>.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Distal_femur_fractures">Distal femur fractures</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=7" title="Edit section: Distal femur fractures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Fractures of the inferior or distal femur may be complicated by separation of the condyles, resulting in misalignment of the articular surfaces of the knee joint, or by hemorrhage from the large popliteal artery that runs directly on the posterior surface of the bone. This fracture compromises the blood supply to the leg (an occurrence that should always be considered in knee fractures or dislocations).<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=8" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A 2015 Cochrane review (updated in 2022) found that available evidence for treatment options of distal femur fractures is insufficient to inform clinical practice and that there is a priority for a high-quality trial to be undertaken.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Open fractures must undergo urgent surgery to clean and repair them, but closed fractures can be maintained until the patient is stable and ready for surgery.<sup id="cite_ref-Büchele_2022_9-0" class="reference"><a href="#cite_note-Büchele_2022-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Skeletal_traction">Skeletal traction</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=9" title="Edit section: Skeletal traction"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Available evidence suggests that treatment depends on the part of the femur that is fractured. <a href="/wiki/Traction_splint" title="Traction splint">Traction</a> may be useful for femoral shaft fractures because it counteracts the force of the muscle pulling the two separated parts together, and thus may decrease bleeding and pain.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Traction should not be used in femoral neck fractures or when there is any other trauma to the leg or <a href="/wiki/Pelvis" title="Pelvis">pelvis</a>.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Marx2014_13-0" class="reference"><a href="#cite_note-Marx2014-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> It is typically only a temporary measure used before surgery. It is only considered definitive treatment for patients with significant <a href="/wiki/Comorbidity" title="Comorbidity">comorbidities</a> that contraindicate surgical management.<sup id="cite_ref-:3_14-0" class="reference"><a href="#cite_note-:3-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="External_fixators">External fixators</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=10" title="Edit section: External fixators"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/External_fixation" title="External fixation">External fixators</a> can be used to prevent further damage to the leg until the patient is stable enough for surgery.<sup id="cite_ref-:3_14-1" class="reference"><a href="#cite_note-:3-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> It is most commonly used as a temporary measure. However, for some select cases it may be used as an alternative to intramedullary nailing for definitive treatment.<sup id="cite_ref-:4_15-0" class="reference"><a href="#cite_note-:4-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Intramedullary_nailing">Intramedullary nailing</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=11" title="Edit section: Intramedullary nailing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>For femoral shaft fractures, reduction and intramedullary nailing is currently recommended.<sup id="cite_ref-:3_14-2" class="reference"><a href="#cite_note-:3-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The bone is re-aligned, then a metal rod is placed into the femoral bone marrow, and secured with nails at either end. This method offers less exposure, a 98–99% union rate, lower infection rates (1–2%) and less muscular scarring.<sup id="cite_ref-:3_14-3" class="reference"><a href="#cite_note-:3-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:4_15-1" class="reference"><a href="#cite_note-:4-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Rehabilitation">Rehabilitation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=12" title="Edit section: Rehabilitation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>After surgery, the patient should be offered physiotherapy and try to walk as soon as possible, and then every day after that to maximise their chances of a good recovery.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Outcomes">Outcomes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=13" title="Edit section: Outcomes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>These fractures can take at least 4–6 months to heal.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Since femoral shaft fractures are associated with violent trauma, there are many adverse outcomes, including <a href="/wiki/Fat_embolism" class="mw-redirect" title="Fat embolism">fat embolism</a>, <a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">acute respiratory distress syndrome (ARDS)</a>, multisystem organ failure, and shock associated with severe blood loss.<sup id="cite_ref-:2_4-4" class="reference"><a href="#cite_note-:2-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Open fractures can result in infection, osteomyelitis, and sepsis.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=14" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Femoral shaft fractures occur in a bimodal distribution, whereby they are most commonly seen in males age 15-24 (due to high energy trauma) and females aged 75 or older (pathologic fractures due to <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a>, low-energy falls).<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:3_14-4" class="reference"><a href="#cite_note-:3-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> In Germany, femoral fractures are the most common type of fracture seen and treated in hospitals.<sup id="cite_ref-Büchele_2022_9-1" class="reference"><a href="#cite_note-Büchele_2022-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Femoral_fracture&action=edit&section=15" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFBucholzJones1991" class="citation journal cs1">Bucholz RW, Jones A (December 1991). "Fractures of the shaft of the femur". <i>The Journal of Bone and Joint Surgery. American Volume</i>. <b>73</b> (10): 1561–1566. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2106%2F00004623-199173100-00015">10.2106/00004623-199173100-00015</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1748704">1748704</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Journal+of+Bone+and+Joint+Surgery.+American+Volume&rft.atitle=Fractures+of+the+shaft+of+the+femur&rft.volume=73&rft.issue=10&rft.pages=1561-1566&rft.date=1991-12&rft_id=info%3Adoi%2F10.2106%2F00004623-199173100-00015&rft_id=info%3Apmid%2F1748704&rft.aulast=Bucholz&rft.aufirst=RW&rft.au=Jones%2C+A&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFemoral+fracture" class="Z3988"></span></span> </li> <li id="cite_note-:0-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRockwood_JrGreenBucholz2010" class="citation book cs1">Rockwood Jr CA, Green DP, Bucholz RW (2010). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/rockwoodgreensfr0002unse_r0i5"><i>Rockwood and Green's fractures in adults</i></a></span> (7th ed.). 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href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q4350503" class="extiw" title="d:Q4350503">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/S72">S72</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=68005264">68005264</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/AO_Foundation" title="AO Foundation">AO Foundation</a></b>: <a rel="nofollow" class="external text" href="https://www2.aofoundation.org/wps/portal/31-A1">- 33-C3 31-A1 - 33-C3</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Fractures_and_cartilage_damage" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Fractures" title="Template:Fractures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Fractures" title="Template talk:Fractures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Fractures" title="Special:EditPage/Template:Fractures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Fractures_and_cartilage_damage" style="font-size:114%;margin:0 4em"><a href="/wiki/Bone_fracture" title="Bone fracture">Fractures</a> and <a href="/wiki/Articular_cartilage_damage" title="Articular cartilage damage">cartilage damage</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Avulsion_fracture" title="Avulsion fracture">Avulsion fracture</a></li> <li><a href="/wiki/Chalkstick_fracture" title="Chalkstick fracture">Chalkstick fracture</a></li> <li><a href="/wiki/Greenstick_fracture" title="Greenstick fracture">Greenstick fracture</a></li> <li><a href="/wiki/Open_fracture" title="Open fracture">Open fracture</a></li> <li><a href="/wiki/Pathologic_fracture" title="Pathologic fracture">Pathologic fracture</a></li> <li><a href="/wiki/Spiral_fracture" title="Spiral fracture">Spiral fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_head" title="Human head">Head</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Basilar_skull_fracture" title="Basilar skull fracture">Basilar skull fracture</a></li> <li><a href="/wiki/Blowout_fracture" class="mw-redirect" title="Blowout fracture">Blowout fracture</a></li> <li><a href="/wiki/Mandibular_fracture" title="Mandibular fracture">Mandibular fracture</a></li> <li><a href="/wiki/Nasal_fracture" title="Nasal fracture">Nasal fracture</a></li> <li><a href="/wiki/Le_Fort_fracture_of_skull" title="Le Fort fracture of skull">Le Fort fracture of skull</a></li> <li><a href="/wiki/Zygomaticomaxillary_complex_fracture" title="Zygomaticomaxillary complex fracture">Zygomaticomaxillary complex fracture</a></li> <li><a href="/wiki/Zygoma_fracture" title="Zygoma fracture">Zygoma fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Spinal_fracture" title="Spinal fracture">Spinal fracture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cervical_fracture" title="Cervical fracture">Cervical fracture</a> <ul><li><a href="/wiki/Burst_fracture" title="Burst fracture">Burst fracture</a></li> <li><a href="/wiki/Chance_fracture" title="Chance fracture">Chance fracture</a></li> <li><a href="/wiki/Clay-shoveler_fracture" title="Clay-shoveler fracture">Clay-shoveler fracture</a></li> <li><a href="/wiki/Craniocervical_instability" title="Craniocervical instability">Craniocervical instability</a></li> <li><a href="/wiki/Flexion_teardrop_fracture" title="Flexion teardrop fracture">Flexion teardrop fracture</a></li> <li><a href="/wiki/Hangman%27s_fracture" title="Hangman's fracture">Hangman's fracture</a></li> <li><a href="/wiki/Holdsworth_fracture" title="Holdsworth fracture">Holdsworth fracture</a></li> <li><a href="/wiki/Jefferson_fracture" title="Jefferson fracture">Jefferson fracture</a></li> <li><a href="/wiki/Vertebral_compression_fracture" title="Vertebral compression fracture">Vertebral compression fracture</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rib" title="Rib">Ribs</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Rib_fracture" title="Rib fracture">Rib fracture</a></li> <li><a href="/wiki/Sternal_fracture" title="Sternal fracture">Sternal fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Shoulder_fracture" class="mw-redirect" title="Shoulder fracture">Shoulder fracture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clavicle_fracture" title="Clavicle fracture">Clavicle</a></li> <li><a href="/wiki/Scapular_fracture" title="Scapular fracture">Scapular</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Arm_fracture" class="mw-redirect" title="Arm fracture">Arm fracture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Humerus_fracture" title="Humerus fracture">Humerus fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proximal_humerus_fracture" title="Proximal humerus fracture">Proximal</a></li> <li><a href="/wiki/Supracondylar_humerus_fracture" title="Supracondylar humerus fracture">Supracondylar</a></li> <li><a href="/wiki/Holstein%E2%80%93Lewis_fracture" title="Holstein–Lewis fracture">Holstein–Lewis fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Forearm_fracture" class="mw-redirect" title="Forearm fracture">Forearm fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ulna_fracture" title="Ulna fracture">Ulna fracture</a> <ul><li><a href="/wiki/Monteggia_fracture" title="Monteggia fracture">Monteggia fracture</a></li> <li><a href="/wiki/Hume_fracture" title="Hume fracture">Hume fracture</a></li></ul></li> <li><a href="/wiki/Radius_fracture" class="mw-redirect" title="Radius fracture">Radius fracture</a>/<a href="/wiki/Distal_radius_fracture" title="Distal radius fracture">Distal radius</a> <ul><li><a href="/wiki/Galeazzi_fracture" title="Galeazzi fracture">Galeazzi</a></li> <li><a href="/wiki/Colles%27_fracture" title="Colles' fracture">Colles'</a></li> <li><a href="/wiki/Chauffeur%27s_fracture" title="Chauffeur's fracture">Chauffeur's</a></li> <li><a href="/wiki/Smith%27s_fracture" title="Smith's fracture">Smith's</a></li> <li><a href="/wiki/Barton%27s_fracture" title="Barton's fracture">Barton's</a></li> <li><a href="/wiki/Essex-Lopresti_fracture" title="Essex-Lopresti fracture">Essex-Lopresti fracture</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hand_fracture" class="mw-redirect" title="Hand fracture">Hand fracture</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Scaphoid_fracture" title="Scaphoid fracture">Scaphoid</a></li> <li><a href="/wiki/Rolando_fracture" title="Rolando fracture">Rolando</a></li> <li><a href="/wiki/Bennett%27s_fracture" title="Bennett's fracture">Bennett's</a></li> <li><a href="/wiki/Boxer%27s_fracture" title="Boxer's fracture">Boxer's</a></li> <li><a href="/wiki/Busch_fracture" title="Busch fracture">Busch's</a></li> <li><a href="/wiki/Broken_finger" title="Broken finger">Broken finger</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pelvic_fracture" title="Pelvic fracture">Pelvic fracture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Duverney_fracture" title="Duverney fracture">Duverney fracture</a></li> <li><a href="/wiki/Pipkin_fracture" class="mw-redirect" title="Pipkin fracture">Pipkin fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Leg</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Tibia_fracture" class="mw-redirect" title="Tibia fracture">Tibia fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bumper_fracture" class="mw-redirect" title="Bumper fracture">Bumper fracture</a></li> <li><a href="/wiki/Segond_fracture" title="Segond fracture">Segond fracture</a></li> <li><a href="/wiki/Gosselin_fracture" title="Gosselin fracture">Gosselin fracture</a></li> <li><a href="/wiki/Toddler%27s_fracture" title="Toddler's fracture">Toddler's fracture</a></li> <li><a href="/wiki/Pilon_fracture" title="Pilon fracture">Pilon fracture</a> <ul><li><a href="/wiki/Plafond_fracture" class="mw-redirect" title="Plafond fracture">Plafond fracture</a></li></ul></li> <li><a href="/wiki/Tillaux_fracture" title="Tillaux fracture">Tillaux fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Fibular_fracture" class="mw-redirect" title="Fibular fracture">Fibular fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Maisonneuve_fracture" title="Maisonneuve fracture">Maisonneuve fracture</a></li> <li><a href="/wiki/Le_Fort_fracture_of_ankle" class="mw-redirect" title="Le Fort fracture of ankle">Le Fort fracture of ankle</a></li> <li><a href="/wiki/Bosworth_fracture" title="Bosworth fracture">Bosworth fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Combined_tibia_and_fibula_fracture" class="mw-redirect" title="Combined tibia and fibula fracture">Combined tibia and fibula fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Trimalleolar_fracture" title="Trimalleolar fracture">Trimalleolar fracture</a></li> <li><a href="/wiki/Bimalleolar_fracture" title="Bimalleolar fracture">Bimalleolar fracture</a></li> <li><a href="/wiki/Pott%27s_fracture" title="Pott's fracture">Pott's fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a href="/wiki/Crus_fracture" title="Crus fracture">Crus fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Patella_fracture" title="Patella fracture">Patella fracture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background:WhiteSmoke;"><a class="mw-selflink selflink">Femoral fracture</a>:</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hip_fracture" title="Hip fracture">Hip fracture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Foot_fracture" class="mw-redirect" title="Foot fracture">Foot fracture</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lisfranc_injury" title="Lisfranc injury">Lisfranc</a></li> <li><a href="/wiki/Jones_fracture" title="Jones fracture">Jones</a></li> <li><a href="/wiki/Cuneiform_fracture" title="Cuneiform fracture">Cuneiform</a></li> <li><a href="/wiki/March_fracture" title="March fracture">March</a></li> <li><a href="/wiki/Calcaneal_fracture" title="Calcaneal fracture">Calcaneal</a></li> <li><a href="/wiki/Broken_toe" title="Broken toe">Broken toe</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Femoral_fracture&oldid=1240000841">https://en.wikipedia.org/w/index.php?title=Femoral_fracture&oldid=1240000841</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Bone_fractures" 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