from Section 24 - Orthopedic Surgery
Published online by Cambridge University Press: 05 September 2013
The femur is the largest bone in the body and has a large soft tissue muscle mass surrounding it. The femoral shaft includes the region 5 cm below the lesser trochanter and 9 cm above the knee joint, and is termed the diaphysis. The estimated incidence of fractures of the femoral shaft in the USA is around one fracture per 10,000 persons per year. There is a bimodal age distribution of femur fractures with one peak in the 20s and one peak in the 60s.
Most femur fractures tend to occur secondary to high-energy trauma such as motor vehicle accidents, pedestrians struck by vehicles, falls from a height, or gunshots. The force required to fracture a femur may also cause a multitude of other associated injuries, most commonly to the head and chest. Therefore, a thorough and complete evaluation by a systematic protocol is warranted followed by any needed resuscitation. High-energy femoral shaft fractures may lose up to 1–3 units of blood into the thigh musculature causing hemodynamic instability, so close monitoring is indicated.
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