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Femur Fracture, Emergency Medicine

Alexander D. Miller Reviewed 06/2017



Fractures classified according to: 
  • Location:

    • Proximal 3rd (subtrochanteric region)

    • Middle 3rd

    • Distal 3rd (distal metaphyseal–diaphyseal junction)

  • Geometry:

    • Spiral

    • Transverse

    • Oblique

    • Segmenta...


Signs and Symptoms


  • Thigh pain, deformity, swelling, shortening

  • Patient unable to move hip or knee

  • Commonly presents as multitrauma:

    • Chest, abdominal, pelvic, hip, knee injury, including d...



  • Immobilization of the extremity and application of a traction splint can be important for tamponade of further blood loss into the thigh:

    • Backboard immobilization, rigid splinting...



Admission Criteria

  • All femur fractures must be admitted except as noted below in Discharge Criteria.

  • Any suspicion of NAT in children

Discharge Criteria

In certain rare circumstances ...

Pearls and Pitfalls

  • Due to the high-energy mechanism required to incur a femoral fracture, other associated traumatic injuries must be ruled out.

  • Document neurovascular function on initial assessment a...

Additional Reading

  • Barnett  P. Alternatives to sedation for painful procedures.Pediatr Emerg Care.  2009;25(6):415–419.

  • Hospenthal  DR, Murray  CK, Andersen  RC, et al. Guidelines for the preventi...



  • 820.22 Closed fracture of subtrochanteric section of neck of femur

  • 821.00 Closed fracture of unspecified part of femur

  • 821.01 Closed fracture of shaft of femur

  • 821.29 Other closed fracture of l...

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