MANUAL MINORS
Femur injuries, involving the long and strong bone in the thigh, can vary in severity from simple fractures to complex injuries requiring urgent surgical intervention.
As the femur is crucial for mobility and bears a significant amount of weight, injuries to this bone can have a major impact on the patient’s functionality and quality of life.
From the perspective of an emergency physician working in an A&E department, here is how these injuries are addressed
Category | Description |
|---|---|
Femur Fractures | |
Fracture of the Femoral Head | A fracture at the top of the femur where it articulates with the pelvis. Symptoms include severe groin pain, inability to move the leg, and possible leg deformity (often externally rotated and shortened). |
Fracture of the Femoral Neck | A fracture just below the femoral head. Symptoms include groin pain, inability to bear weight, and limited leg movement. |
Intertrochanteric Fracture | A fracture between the greater and lesser trochanter. Symptoms include hip pain, inability to move the leg, and possible deformity. |
Fracture of the Greater and Lesser Trochanter | A fracture in the bony prominences of the femur. Fractures of the greater trochanter cause hip and buttock pain, while those of the lesser trochanter cause groin and inner thigh pain. |
Diaphyseal Fracture | A fracture in the shaft of the femur. Symptoms include severe pain, visible deformity in the thigh, leg shortening, and difficulty moving the leg. |
Supracondylar Fracture | A fracture just above the knee joint. Symptoms include severe pain, swelling in the knee, and difficulty moving the leg. |
Condylar Fracture | A fracture in the lower part of the femur near the knee. Symptoms include knee pain, swelling, and possible restrictions in knee movement. |
Femur Dislocations | |
Posterior Dislocation of the Femoral Head | Displacement of the femoral head backwards from the acetabulum. Symptoms include severe hip pain, leg deformity (often internally rotated and adducted), and difficulty moving the leg. |
Anterior Dislocation of the Femoral Head | Displacement of the femoral head forwards. Symptoms include hip pain, leg deformity (often externally rotated and abducted), and difficulty moving the leg. |
Soft Tissue Injuries | |
Sprains and Strains | Injuries to the ligaments and muscles around the femur. Symptoms include pain in the affected area, swelling, and difficulty moving the leg. |
Contusions and Haematomas | Caused by direct trauma to the femur, resulting in pain, swelling, and bruising in the affected area. |
Vascular and Nerve Injuries | |
Vascular Injuries | Damage to major blood vessels due to femur fractures, leading to internal bleeding. Symptoms may include signs of shock such as pallor, sweating, and low blood pressure. |
Nerve Injuries | Damage to nerves near the fractures, resulting in leg weakness, sensory alterations, and sphincter dysfunction. |
Stress Injuries | |
Stress Fractures | Small fractures due to repetitive overuse. Symptoms include gradual pain in the affected area, increasing with activity and easing with rest. |
Management Protocol
Initial Assessment:
Clinical History and Physical Examination: Determine the mechanism of injury, assess femur pain and functionality, and check for signs of vascular or neurological compromise.
Immobilisation: Use splints or immobilisation devices to stabilise the femur and prevent further movement.
Diagnostic Imaging:
X-rays: To evaluate femur fractures and dislocations.
CT Scan: For a more detailed assessment of complex fractures and soft tissue injuries.
MRI: To evaluate stress injuries and soft tissue damage.
Initial Treatment:
Pain Management: Administer analgesics and anti-inflammatory drugs as required.
Treatment of Soft Tissue Injuries: Apply ice, elevate the leg, and use compresses to control swelling.
Surgical Intervention:
Fractures and Dislocations: Surgery may be necessary to realign fractured or dislocated bones and stabilise the femur.
Vascular and Nerve Injuries: In severe cases, surgery may be required to repair damaged blood vessels or nerves.
Follow-up and Rehabilitation:
Physical Rehabilitation: To regain mobility and strength in the femur, as well as to prevent long-term complications.
Ongoing Monitoring: To assess recovery and prevent complications such as infections or healing issues.
Each femur injury must be handled carefully to ensure proper recovery and restore the patient’s functionality.
コメント