In a prospective study 52 patients with an isolated fracture of the distal ulna were treated with a belowelbow plaster cast. This fracture is a hallmark of nonaccidental injury. Tibia shaft fracture is a fracture of the proximal upper third of the tibia lower leg bone. Box 5000, fin90014 university of oulu, finland 2004 oulu, finland abstract although nonoperative treatment is recognized as an effective treatment method for humeral shaft. Treatment of isolated distal ulnar shaft fractures with below. Usually occur in young men after high energy trauma and elderly women even after a low energy fall. Every child with a femoral shaft fracture should receive a careful, complete physical exam to avoid missing associated injuries. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures. Injuries associated with femoral shaft fractures were very frequent 46. Femoral shaft fractures can be classified with the winquist classification or the aoota classification. An axle shaft of fork lift failed at operation within 296 h of service. Interlocking intramedullary nailing is a widely accepted treatment for the patients with femoral shaft fracture, with the union rate reported from. Femoral shaft fracture, also known as broken thighbone, is the breakage of the shaft of the femur or thighbone. Shaft fracture definition of shaft fracture by medical.
Treatment of the humeral shaft fractures pubmed central pmc. There is a debate about the choice of operative intervention in humerus shaft fractures requiring surgical intervention. Pdf on oct 12, 20, dp mahara and others published fracture shaft of femur in children with newly designed femoral brace find, read and cite all the research you need on researchgate. Surgical treatment is reserved for specific conditions. In the femoral shaft, this refers to a fracture in any part of the bone from the lesser trochanter to the metaphyseal flare of the condylar region of the knee. Twenty patients of interlocking nailing and sixteen patients of. Still, surgical management is indicated in certain situations, including polytraumatic injuries, open fractures, vascular injury, ipsilateral articular fractures. If the patient is to be transferred to another hospital, the leg should be immobilised in a thomas type splint if available or a backslab. Children that sustain femur fractures prior to walking age should be screened for nonaccidental.
The radius and ulna are the two long bones of the forearm that allow the hand and wrist to move as well as take part in elbow function. In two large retrospective series of femoral shaft nonunions, the wave plate led to union after a single surgery in the vast majority of cases e. Fracture of the humeral shaft associated to elbow dislocation and. Fracture of shaft of femur 1 fracture of shaft of femur 2. Femoral shaft fracture a fracture of the shaft of the femur is usually sustained by a severe violence,as may occur in a road accident. Treatment of femur fracture with associated vascular injury. Femoral shaft fractures should be put into skin traction 10% of body weight to help with pain management. Spiral fracture the fracture line encircles the shaft like the stripes on a candy cane. Ii met an accident on 16 nov2001 and suffered a femur shaft fracture of left thigh.
Dec 07, 2017 femoral shaft fracture, also known as broken thighbone, is the breakage of the shaft of the femur or thighbone. Physiologically induced motion at the fracture site favors healing of the fracture. The winquist classification is based on the amount of comminution. They are typically sustained in highimpact trauma, such as car crashes, due to the large amount of force needed to break the bone. Humeral shaft fractures combined with elbow dislocation and fracture of the distal third of the bones of the forearm are uncommon. Fractures of the femur and tibial shaft sciencedirect. Type i represents a femoral shaft fracture with no comminution or a small butterfly fragment less than 25% of the bone. Nonoperative treatment is still the standard treatment of isolated humeral shaft fractures, although this method can present unsatisfactory results. Anteroposterior a and lateral b radiographs showing nonunion of a tibial shaft fracture in a 74yearold man 6 months after he.
What is femoral shaft fracturetypescausestreatmenthealing. Adults with severe injury who underwent definitive fixation of a femoral shaft fracture at a level i or ii trauma center participating in acs tqip. Pediatric femoral shaft fractures open access journals. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter see hip fractures. The art of femoral fracture care involves a balancing act between anatomic. The rate of associated femoral neck fracture with an established femoral shaft fracture ranges from 25% to 6% of these, up to 33% will be missed on initial injury radiographs. Shaft of femur definition of shaft of femur by medical. Fracture shaft of femur a femoral shaft fracture is a fracture of the femoral diaphysis occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle 6. Up to 30% of femoral shaft fractures in children younger than 4 years is attributable to child abuse, and the most common cause of femur fractures in the nonambulatory infant is nonaccidental trauma. Jan 26, 20 tibia shaft fractures tsf are common for men and women and cause substantial morbidity, healthcare use, and costs. We retrospectively analyzed medical claims in large. Oblique fracture the fracture has an angled line across the shaft.
Invasive plate osteosynthesis, temporary external fixation, locking compression plate. Failure analysis of axle shaft of a fork lift sciencedirect. Intramedullary nailing intramedullary nailing imn is the goldstandard in treating patients with femoral shaft fractures figs 1 and 2. Timing of femoral shaft fracture fixation following major trauma. Fortythree percent to 69% of fractures involve the mid shaft. Scribd is the worlds largest social reading and publishing site. However, associated injuries may have some influence on method used together with the type of fracture, apart from the experience of the surgeon. A fracture of long bone in which the fracture line passes through or across the shaft. The impact of nonunions on healthcare use and costs is poorly described. Jun 19, 2016 throwing motions, and violent muscle contractions can also cause humeral shaft fractures. With an ipsilateral femoral shaft fracture, rotating the lower leg will not change the proximal femur orientation until fixation of the shaft component is achieved. Apr 20, 2016 fracture shaft of femur a femoral shaft fracture is a fracture of the femoral diaphysis occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle 6.
Operative treatment for femoral shaft nonunions, a systematic. Tibial shaft fractures management and treatment options. Fractures should be described by location as proximal, middle, distal, or at the junction of the proximal and middle thirds or middle and distal thirds holsteinlewis fracture, see chapter 2. A section of fractured axle shaft made of inductionhardened steel was analyzed to determine the root cause of the failure. One fracture displaced while in the plaster, so that there was no longer any bone contact between. Epidemiology common injury due to major violent trauma 1 femur fracture 10,000 people more common in people 65 yr motor vehicle. Femoral shaft fractures can also result in major physical impairment due to potential fracture shortening, malalignment, or prolonged immobilization of the extremity with casting or traction. Radius and ulna fractures are more common in men than in women because they are more often to be in motor vehicle accidents or play sports that contribute to getting forearm fractures of the radius and ulna. Femoral shaft fractures in children journal musculoskeletal. Introduction tibia shaft fractures are the most common long bone fractures 24. Fracture of shaft and distal part of femoral bone prepared by. Only pape j trauma 1993 has shown a deleterious pulmonary effect to immediate reamed intramedullary nailing in.
The long, straight part of the femur thighbone is called the femoral shaft. Comminuted fracture the bone has broken into three or more pieces. The shaft transmits torque from discrepancy to wheel through planetary gear arrangement. We retrospectively analyzed medical claims in large u. Immediate hip spica for unstable femoral shaft fractures in preschool children. The femur is the longest and strongest bone in the body, and it takes a great deal of force to break it. Femoral shaft fractures in emergency medicine clinical. Femoral shaft fractures in children journal free download as powerpoint presentation. Flinkkila, tapio, intramedullary nailing of humeral shaft fractures division of orthopaedic and trauma surgery, department of surgery, university of oulu, p.
It is a fracture of femoral diaphysis occurring between 5cm distal to lesser trochanter and 5cm proximal to adductor tubercle. Surgical factors contributing to nonunion in femoral shaft fracture. Femoral shaft fractures orthopaedic trauma association. Femur shaft fractures broken thighbone orthoinfo aaos. Fractures in the shafts of both the femur and tibia are common injuries. There is no consensus on the best management of a closed midshaft stable tibia fracture amongst trauma experts in a metaanalysis by littenberg et al jbjsa 1998 the only strong conclusions that could be reached were that closed treatment has a lower risk. Research article injuries associated with femoral shaft. Aug 07, 20 humeral shaft fractures account for 1 to 3% of all fractures in adults and for 20% of all humeral fractures. They usually occur in young and active patients and are often due to highenergy trauma like motor vehicle accidents, sports or falls.
A femoral fracture is a bone fracture that involves the femur. Humeral shaft fractures are the second most common birth fracture. When there is a break anywhere along this length of bone, it is called a femoral shaft fracture. Our goal was to investigate patient characteristics and healthcare use and costs associated with tsf in patients with and without nonunion. The art of femoral fracture care involves a balancing act between anatomic alignment and early functional rehabilitation of the limb. Femoral shaft fractures are an emergency indication and should be promptly stabilized as delayed stabilization is associated with increased morbidity, particularly in the lungs and a longer hospital stay 9. Fractures of the shaft of radius and ulna limbs anatomy. Nonsurgical management of humeral shaft fractures with functional bracing gained popularity in the 1970s, and this method is arguably the standard of care for these fractures. Bone grafting alone as a treatment of a failed union of a femoral shaft fracture cannot be recommended. Spiral fractures that are related to low energy trauma situate in the middle third of. Humeral shaft fractures in children under four years should lead the examiner to be alert for other signs of nonaccidental injury. Jul 27, 20 in two large retrospective series of femoral shaft nonunions, the wave plate led to union after a single surgery in the vast majority of cases e.
Thus it is the most commonly fractured long bone in the body. Know the types, causes, signs, symptoms, treatment, healing time, risk factors and complications of femoral shaft fracture. The humeral shaft is the region just proximal to the supracondylar ridge and immediately distal to the surgical neck. A twisting force to the thigh causes this type of fracture. Tibia shaft fractures tsf are common for men and women and cause substantial morbidity, healthcare use, and costs. Due to the location of the tibia, it is frequently injured. Contamination of the fracture site and devitalization of the softtissue envelope greatly increase the risk of infection, nonunion, and wound complications. Details of thomas traction in children are given on the traction page if cost is a problem the child may be placed in a spica cast once the fracture is partially united week 2.