Femoral Fractures

FEMORAL FRACTURES
Subtrochanteric Fractures
Femoral Shaft Fractures
Supracondylar Fractures
Mechanism of Injury
Usually the result of high-energy trauma
Subtrochanteric fractures may be due to pathologic fractures
Examination
Deformed and swollen thigh at the site of fractures
Exclude neurovascular injuries and compartment syndrome
X-rays
AP and lateral views of the femur
AP and lateral of the hip or knee if appropriate
Management
In view of high-energy trauma, exclude life-threatening injuries and resuscitate
Femoral fracture alone can lead to blood loss of up to 1.5 litres
Keep NBM, IV drip
FBC, U/E/Cr/Glu, GXM 2 pints, CXR, ECG
IM Voltaren 50 - 75mg for analgesia
Apply splint for resuscitation as this will reduce the volume of blood loss. Splintering also relieves pain.
Disposition
Once patient stabilised,
Admit to Ortho Dept if no associated unstable general surgical conditions
Admit to Surgical Dept if associated cardiothoracic, abdominal or unstable head injuries