Femoral shaft and distal femoral fracture

Femoral shaft fractures and distal femoral fractures may occur in young due to high energy trauma or elderly due to low energy trauma. They’re classified according to Winquist-Hansen. Treatment is ORIF.

Classification

These fractures are classified according to the AO/ASIF classification or Winquist-Hansen classification.

Clinical features

Femoral shaft fractures are usually clinically obvious due to local presence of pain, swelling, and deformity of the thigh. Soft tissue injury and bleeding are common.

Diagnosis and evaluation

X-ray is usually sufficient but should include hip and knee as well to look for concomitant injuries.

Treatment

Treatment is almost always surgical. Conservative treatment involves skeletal traction or a hip spica cast and may be used for infants or if the patient is inoperable. In all other cases, surgical treatment is preferred.

Surgical options include reamed intramedullary nailing, antegrade screw fixation (with cancellous screw or dynamic condylar screw), or plate fixation (with LISS or LCP). LISS (less invasive stabilising system) and LCP (locking compression plate) are types of plates for internal fixation.