Mid-shaft femur fracture: Difference between revisions

Revision as of 05:36, 11 January 2020

Includes all subtrochanteric femur fractures

Location of femur fractures

Occurs with severe trauma or in association with pathologic bone
- Blood loss can be substantial (average loss = 1L)

Clinical presentation is similar to intertrochanteric fracture
- Affected leg is shortened and externally rotated

Radiography
- Obtain films of knee, femur, and hip for operative planning and to assess for other injury
Pre-op labs
- CBC
- Chem 7
- PT/PTT
- Type & Screen

Acute pain management
Open fractures require immediate IV antibiotics and urgent surgical washout
Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
Consider risk for compartment syndrome
Resuscitation per ATLS guidelines

Consider traction splint
- Little evidence to support its use^[1]
- Theoretical benefit of traction splinting is reduction in bleeding and improved pain
- Sager and Hare splints are commonly used by EMS providers
- Buck's traction used by ortho

↑ Agrawal Y, Karwa J, Shah N, et al. Traction splint: to use or not to use. J Perioper Pract. 2009; 19(9):295-298.

Authors:

@@ Line 29: / Line 29: @@
 **Little evidence to support its use<ref>Agrawal Y, Karwa J, Shah N, et al. Traction splint: to use or not to use. J Perioper Pract. 2009; 19(9):295-298.</ref>
 **Theoretical benefit of traction splinting is reduction in bleeding and improved pain
-**Sagar and Hare splints are commonly used by EMS providers
+**Sager and Hare splints are commonly used by EMS providers
 **Buck's traction used by ortho