Fractures & Trauma

Ankle Anatomy

The ankle joint is composed of three bones: the tibia, fibula, and talus which are articulated together. The ends of the fibula and tibia (lower leg bones) form the inner and outer malleolus, which are the bony protrusions of the ankle joint that you can feel and see on either side of the ankle. The joint is protected by a fibrous membrane called a joint capsule, and filled with synovial fluid to enable smooth movement.

How do Ankle Injuries Occur?

Ankle injuries are very common in athletes and in people performing physical work, often resulting in severe pain and impaired mobility. Pain after ankle injuries can either be from a torn ligament and is called ankle sprain or from a broken bone which is called ankle fracture.

What is an Ankle Fracture?

Ankle fracture is a painful condition where there is a break in one or more bones forming the ankle joint. The ankle joint is stabilized by different ligaments and other soft tissues, which may also be injured during an ankle fracture.

Causes of Ankle Fractures

Ankle fractures occur from excessive rolling and twisting of the ankle, usually occurring from an accident or activities such as jumping or falling causing sudden stress to the joint.

Symptoms of Ankle Fractures

With an ankle fracture, there is immediate swelling and pain around the ankle as well as impaired mobility. In some cases, blood may accumulate around the joint, a condition called hemarthrosis. In cases of severe fracture, deformity around the ankle joint is clearly visible where bone may protrude through the skin.

Types of Ankle Fractures

Ankle fractures are classified according to the location and type of ankle bone involved. The different types of ankle fractures are:

• Lateral Malleolus fracture in which the lateral malleolus, the outer part of the ankle is fractured.
• Medial Malleolus fracture in which the medial malleolus, the inner part of the ankle, is fractured.
• Posterior Malleolus fracture in which the posterior malleolus, the bony hump of the tibia, is fractured.
• Bimalleolar fractures in which both lateral and medial malleolus bones are fractured
• Trimalleolar fractures in which all three lateral, medial, and posterior bones are fractured.
• Syndesmotic injury, also called a high ankle sprain, is usually not a fracture, but can be treated as a fracture.

Diagnosis of Ankle Fractures

The diagnosis of the ankle injury starts with a physical examination, followed by X-rays and CT scan of the injured area for a detailed view. Usually it is very difficult to differentiate a broken ankle from other conditions such as a sprain, dislocation, or tendon injury without having an X-ray of the injured ankle. In some cases, pressure is applied on the ankle and then special X-rays are taken. This procedure is called a stress test. This test is employed to check the stability of the fracture to decide if surgery is necessary or not. In complex cases, where detail evaluation of the ligaments is required an MRI scan is recommended.

Treatment for Ankle Fracture

Immediately following an ankle injury and prior to seeing a doctor, you should apply ice packs and keep the foot elevated to minimize pain and swelling.

The treatment of ankle fracture depends upon the type and the stability of the fractured bone. Treatment starts with non-surgical methods, and in cases where the fracture is unstable and cannot be realigned, surgical methods are employed.

In non-surgical treatment, the ankle bone is realigned and special splints or a plaster cast is placed around the joint, for at least 2-3 weeks.

With surgical treatment, the fractured bone is accessed by making an incision over the ankle area and then specially designed plates are screwed onto the bone, to realign and stabilize the fractured parts. The incision is then sutured closed and the operated ankle is immobilized with a splint or cast.

Postoperative Care Following Ankle Fracture Surgery

After ankle surgery, you will be instructed to avoid putting weight on the ankle by using crutches while walking for at least six weeks.

Physical therapy of the ankle joint will be recommended by the doctor. After 2-3 months of therapy, the patient may be able to perform their normal daily activities.

Risks and Complications Associated with Ankle Fracture Surgery

Risks and complications that can occur with ankle fractures include improper casting or improper alignment of the bones which can cause deformities and eventually arthritis. In some cases, pressure exerted on the nerves can cause nerve damage, resulting in severe pain.

Rarely, surgery may result in incomplete healing of the fracture, which requires another surgery to repair.

Foot Anatomy

The foot has 26 bones, and can be divided into 3 parts:

• The hind foot is comprised of two bones, the talus bone which connects to the bones of the lower leg, and the calcaneus bone which forms the heel.
• The midfoot is comprised of the navicular, cuboid, and three cuneiform bones.
• The forefoot is made up of five metatarsal bones and 14 toe bones called phalanges.

The hind foot is separated from the midfoot by the mediotarsal joint and the midfoot is separated from the forefoot by the Lisfranc joint. Muscles, tendons and ligaments support the bones and joints of the feet enabling them to withstand the entire body’s weight while walking, running and jumping. Despite this, trauma and stress can cause fractures in the foot. Extreme force is required to fracture the bones in the hind foot. The most common type of foot fracture is a stress fracture, which occurs when repeated activities produce small cracks in the bones.

Types of Foot Fractures

Foot fractures can involve different bones and joints and are classified into several types:

• Calcaneal fractures: This type affects the heel bone and occurs mostly because of high-energy collisions. It can cause disabling injuries and if the subtalar joint is involved it is considered a severe fracture.
• Talar fractures: The talus bone helps to transfer weight and forces across the joint. Talus fractures usually occur at the neck or mid portion of the talus.
• Navicular fractures: Navicular fractures are rare and include mostly stress fractures that occur with sports activities, such as running and gymnastics, because of repeated loading on the foot.
• Lisfranc fractures: This type of fracture occurs due to excessive loading on the foot, which leads to stretching or tearing of the midfoot ligaments.

Causes of Foot Fractures

Foot fractures commonly occur because of a fall, motor vehicle accident, dropping a heavy object on your foot, or from overuse such as with sports.

Symptoms of Foot Fractures

The common symptoms of a foot fracture include pain, bruising, tenderness, swelling, deformity and inability to bear weight.

Diagnosis of Foot Fractures

Your doctor diagnoses a foot fracture by reviewing your medical history and performing a thorough physical examination of your foot. Imaging tests such as X-rays, MRI or CT scan may be ordered to confirm the diagnosis. Navicular fractures can be especially difficult to diagnose without imaging tests.

Treatment of Foot Fractures

Treatment depends on the type of fracture sustained. For mild fractures, nonsurgical treatment is advised and includes rest, ice, compression, and elevation of the foot. Your doctor may suggest a splint or cast to immobilize the foot. For more severe fractures, surgery will be required to align, reconstruct or fuse the joints. Bone fragments may be held together with plates and screws.

Physical therapy may be recommended to improve range of motion and strengthen the foot muscles. Weight bearing however should be a gradual process with the help of a cane or walking boot.

What is a Heel Fracture?

The calcaneus or heel bone is a large bone found on the rear part of the foot. The calcaneus connects with the talus and cuboid bones to form the subtalar joint of the foot. A heel fracture is a break in the calcaneus bone due to trauma or disease conditions.

Types of Heel Fractures

The types of fracture to the calcaneus depend on the severity and include stable fractures, displaced fractures, open fractures, closed fractures and comminuted fractures.

Causes of Heel Fractures

A fracture of the calcaneus is most commonly due to a traumatic event such as falling from a height, twisting injury, motor accidents, sports injuries and ankle sprain.

Complications of Heel Fractures

Fracture of the calcaneus is considered serious and can cause longstanding problems if not treated correctly. Stiffness and pain in the joint and arthritis are commonly reported risks of a calcaneal fracture.

Symptoms of Heel Fractures

The commonly seen signs and symptoms of calcaneal fractures are

• Pain in the heel
• Swelling in the heel
• Bruises in the heel
• Inability to walk or bear weight on the foot

Diagnosis of Heel Fractures

The evaluation of the calcaneal fracture is done by imaging i.e., X-ray and CT scan. Based on the severity of the fracture, the doctor recommends the plan of treatment.

Treatment of Heel Fractures

Calcaneal fractures are treated based on the type of fracture and extent of soft tissue damage.

• Nonsurgical treatment
  • Rest, ice, compression, and elevation (R.I.C.E.):is the most commonly used treatment option. Staying off (resting) the injured foot can heal the fracture. Covering the affected area with ice packs over a towel reduces swelling and pain. Compression stockings and elastic bandages can also aid in healing the pain. Positioning the feet above the level of heart reduces swelling.
  • Immobilization:Casting the injured foot prevents the fractured bone from moving. Walking with the help of crutches is advisable to avoid bearing body weight until healing has occurred.
• Surgical treatment
  • Open reduction and internal fixation:This surgery involves putting the bone fragments back together with metal plates and screws to reposition them and set them to normal alignment.
  • Percutaneous screw fixation:This is the best preferred treatment in cases where the bone pieces are large. The bone can either be pushed or pulled to set into place without making a large incision. Metal screws are then inserted and fixed through small incisions to hold the bone pieces together.

Rehabilitation after Heel Fracture Treatment

Irrespective of the treatment procedure, the patient is recommended to undergo physiotherapy and practice simple exercises regularly to help restore function. This would help the muscles to gain flexibility and after complete recovery, the patient can resume their daily living with normal activities.

Anatomy of the Midfoot

Tarsometatarsal joint refers to the region found in the middle of the foot. It is also called the Lisfranc joints. It is a junction between the tarsal bones (group of seven articulating bones in the foot) and metatarsal bones (a group of five long bones in the foot).

Causes of Lisfranc Fractures

A fracture in the tarsometatarsal region can be due to arthritis or traumatic motor accidents.

Symptoms of Lisfranc Fractures

Tarsometatarsal fractures are characterized by pain, functional impairment and midfoot instability. The appearance of bruises and swelling on the dorsal side of the midfoot are the commonly observed symptoms.

Diagnosis of Lisfranc Fractures

The doctor will first examine the physical condition of the foot by inspection and palpation (feeling with hands). You may be advised to get an X-ray taken. You might also be sent to get a CT or MRI scan done to provide more information about your condition.

Treatment of Lisfranc Fractures

The early stages of injury can be treated by analgesics, steroid injections and by wearing special footwear or casts. Tarsometatarsal joint fusion is recommended if all the non-surgical procedures fail to show efficacy in treating the injury.

What are Stress Fractures of the Foot and Ankle?

A stress fracture is described as a small crack in the bone which occurs from an overuse injury of a bone. It commonly develops in the weight bearing bones of the lower leg and foot. When the muscles of the foot are overworked, or stressed, they are unable to absorb the stress and when this happens the muscles transfer the stress to the bone which results in stress fracture.

Causes of Stress Fractures

Stress fractures are caused by a rapid increase in the intensity of exercise. They can also be caused by impact on a hard surface, improper footwear, and increased physical activity. Athletes participating in certain sports such as basketball, tennis or gymnastics are at a greater risk of developing stress fractures. During these sports the repetitive stress of the foot strike on a hard surface causing trauma and muscle fatigue. An athlete with inadequate rest between workouts can also develop stress fracture.

Females are at a greater risk of developing stress fracture than males, and may be related to a condition referred to as “female athlete triad”. It is a combination of eating disorders, amenorrhea (irregular menstrual cycle), and osteoporosis (thinning of the bones). The risk of developing stress fracture increases in females if the bone weight decreases.

Symptoms of Stress Fractures

The most common symptom is pain in the foot which usually gets worse during exercises and decreases upon resting. Swelling, bruising, and tenderness may also occur at a specific point.

Diagnosis of Stress Fractures

Your doctor will diagnosis the condition after discussing symptoms and risk factors and examines the foot and ankle. Some of the diagnostic tests such as X-ray, MRI scan or bone scan may be required to confirm the fracture.

Treatment of Stress Fractures

Stress fractures can be treated by non-surgical approach which includes rest and limiting the physical activities that involves foot and ankle. If children return too quickly to the activity that has caused stress fracture, it may lead to chronic problems such as harder-to-heal stress fractures. Re-injury can also occur without allowing the stress fracture to completely heal.

Protective footwear may be recommended which helps to reduce stress on the foot. Your doctor may apply cast to the foot to immobilize the leg which also helps to remove the stress. Crutches may be used to prevent the weight of the foot until the stress fracture is healed completely.

Surgery may be required if the fracture is not healed completely by non-surgical treatment. Your doctor makes an incision on the foot and uses internal fixators such as wires, pins, or plates to attach the broken bones of the foot together until healing happens after which these fixators can be removed or may be permanently left inside the body.

Prevention of Stress Fractures

Some of the following measures may help to prevent stress fractures:

• Ensure to start any new sport activity slowly and progress gradually
• Cross-training: You may use more than one exercise with the same intention to prevent injury. For example, you may run on even days and ride a bike on odd days, instead of running every day to reduce the risk of injury from overuse. This limits the stress occurring on specific muscles as different activities use muscles in different ways.
• Ensure to maintain a healthy diet and include calcium and vitamin D-rich foods in your diet
• Ensure that your child uses proper footwear or shoes for any sports activity and avoid using old or worn out shoes

If your child complains of pain and swelling then immediately stop the activities and make sure that your child rests for few days

What is the Talus?

The talus is a small bone at the ankle joint that connects the heel bone and the two bones of the lower leg, enabling the up and down movement of the foot.

Causes of Talus Fractures

Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or twisting of the ankle.

Symptoms of Talus Fractures

The symptoms include severe ankle pain, inability to walk, swelling and tenderness.

Diagnosis of Talus Fractures

When you present to the clinic with these symptoms, your doctor will perform a thorough physical examination and order an X-ray or CT-scan to diagnose the location and severity of the fracture.

Treatment of Talus Fractures

Talus fractures are treated by either non-surgical or surgical methods.

Non-surgical treatment: If the bone has not moved out of alignment, your doctor will place your ankle in a cast for 6 to 8 weeks. You will be advised to perform exercises to help strengthen your foot and ankle and restore range of motion once the cast is removed.

Surgical treatment: Your surgeon realigns the fractured bone and stabilizes it with metal plates and/or screws. Small bone fragments may be removed and replaced with bone graft. After surgery, you may have to wear a cast for 6 to 8 weeks until complete healing. Physical therapy exercises will be initiated to restore movement.

What are Forefoot Fractures?

The forefoot is the front of the foot that includes the toes. Fractures occurring in this part of the foot are painful but very often not disabling.

Causes of Forefoot Fractures

There are 2 types of fractures namely, traumatic fracture and stress fracture. Traumatic fractures occur when there is a direct impact of your foot on a hard surface. Stress fractures are tiny hair line cracks in the bone, most commonly caused due to repeated stress.

Symptoms of Forefoot Fractures

The symptoms of toe and forefoot fractures include pain, bruising, swelling and inability to walk.

Diagnosis of Forefoot Fractures

To detect toe and forefoot fractures, your doctor conducts a physical examination of the foot, and may order X-ray’s to identify the location and severity of the fracture.

Treatment of Forefoot Fractures

Toe and forefoot fractures can be treated by the following ways:

• Rest: Adequate amount of rest can sometimes help heal a traumatic fracture.
• Splinting: Splints may be applied to keep the toe in a fixed position.
• Rigid shoe: A stiff-soled shoe may be recommended to protect the toe and position it correctly.
• Buddy taping: The fractured toe is taped to the adjacent toe with a gauze pad between the toes.
• Surgery: Your doctor realigns the fractured bones using pins or screws to hold the bones together in place until they heal completely.

What is a Tibial Fracture?

The tibia or shinbone is a major bone of the leg which connects the knee to the ankle. A tibial fracture is a break in the continuity of the shinbone (tibia).

What is a Proximal Tibia Fracture?

A proximal tibia fracture is a break in the upper part of the shinbone or tibia. Proximal tibial fractures may or may not involve the knee joint. Fractures that enter the knee joint may cause joint imperfections, irregular joint surfaces, and improper alignment in the legs. This can lead to as joint instability, arthritis, and loss of motion. Proximal tibia fractures may be associated with injury to the surrounding soft tissues including the skin, muscle, nerves, blood vessels, and ligaments.

Causes of Proximal Tibia Fractures

These fractures are caused by stress or trauma or in a bone already compromised by disease, such as cancer or infection.

Symptoms of Proximal Tibia Fractures

The symptoms of tibia fracture include painful weight bearing movements, tenseness around the knee, limitation of movement and deformity around the knee. In some individuals, impairment of blood supply secondary to the fracture may result in a pale or cool foot. Patients may also experience numbness or feelings of ‘pins and needles’ in the foot because of associated nerve injury.

Diagnosis of Proximal Tibia Fractures

The diagnosis of tibial fracture is based on the medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate a soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.

Treatment of Proximal Tibia Fractures

The management of the fracture is based on the severity of the fracture, medical condition of the patient and the patient’s lifestyle.

Non-surgical treatment for Proximal Tibia Fractures

Non-surgical treatment comprises of immobilizing the fractured site with the help of casts or braces to prevent weight bearing and to help the healing process. X-rays are taken at regular intervals to assess the healing process. Weight-bearing and movement are initiated gradually, depending on the nature of the injury and the condition of the patient.

Surgical Treatment for Proximal Tibia Fractures

Surgical treatment is considered to maintain alignment of the fractured bone. External or internal fixators may be used to align the fractured bone segments. If the fracture does not involve the knee joint, rods and plates can be used to stabilize the fracture. For a fracture involving the knee joint, a bone graft may be required to prevent the knee joint from collapsing. An external fixator is used when the surrounding soft tissue is severely damaged, as the use of plate and screw may be harmful.

As the tibial fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long-term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.

How do pediatric thighbone fractures occur?

The femur or thighbone is the largest and strongest bone in the human body. Pediatric thighbone fractures can occur when your child falls hard on the ground and gets hit during sports, automobile accidents, and child abuse. In a thighbone fracture, the broken bones may be aligned or displaced. The fracture can either be closed (with skin intact) or open (with the bone piercing out through the skin).

Symptoms of Pediatric Thighbone Fractures

Your child may experience severe pain, swelling, inability to stand and walk, and limited range of motion of hip or knee.

Diagnosis of Pediatric Thighbone Fracture

Your child’s doctor will conduct a physical examination. An X-ray or CT-scan may be recommended to locate the position and number of fractures, and determine if the growth plate is damaged.

Treatment of Pediatric Thighbone Fractures

Femur fractures may be treated with non-surgical or surgical methods.

Non-surgical Treatment of Pediatric Thighbone Fractures

Non-surgical treatment involves stabilizing the bones,so they can heal and fuse together. Braces, spica casting (cast applied from the chest, down the fractured leg) or traction (placing the leg in a weight system) may be used to ensure that the bones are properly set in their normal position.

Surgery for Pediatric Thighbone Fractures

Surgery is recommended for complicated injuries. Your child’s surgeon aligns the broken bones and uses metal plates and screws to hold the fractured bones together in proper alignment. Your child may have to wear a cast for a few weeks until complete healing. An external fixator may be used in case of open injury to the skin and muscles.

What are Shin bone Fractures?

The tibia or shinbone is a major bone of the leg which connects the knee to the ankle. A tibial fracture is a break in the continuity of the shinbone (tibia).

Types of Shinbone Fractures

• Fractures of the proximal tibia: A proximal tibial fracture is a break in the upper part of the shinbone or tibia. Proximal tibial fractures may or may not involve the knee joint. Fractures that enter the knee joint may cause joint imperfections, irregular joint surfaces, and improper alignment in the legs. This can lead to as joint instability, arthritis, and loss of motion. These fractures are caused by stress or trauma or in a bone already compromised by disease, such as cancer or infection. Proximal tibia fractures can result in injury to the surrounding soft tissues including skin, muscle, nerves, blood vessels, and ligaments.
• Tibial shaft fractures: A tibial shaft fracture is a break that occurs along the length of the tibia or shinbone (larger bone of the lower leg) between the knee and ankle joints. These fractures can occur while playing sports such as soccer and skiing.

Symptoms of Shinbone Fractures

The symptoms of tibia fracture include painful weight bearing movements, tenseness around the knee, limitation of movement and deformity around the knee. In some individuals, impairment of blood supply secondary to the fracture may result in a pale or cool foot. Patients may also experience numbness or feelings of ‘pins and needles’ in the foot because of associated nerve injury.

Diagnosis of Shinbone Fractures

The diagnosis of tibial fracture is based on the medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate a soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.

Treatment of Shinbone Fractures

The management of the fracture is based on the severity of the fracture, medical condition of the patient and the patient’s lifestyle.

Non-surgical treatment comprises of immobilizing the fractured site with the help of casts or braces to prevent weight bearing and to help the healing process. X-rays are taken at regular intervals to assess the healing process. Weight-bearing and movement are initiated gradually, depending on the nature of the injury and the condition of the patient.

Surgical treatment is considered to maintain alignment of the fractured bone. External or internal fixators may be used to align the fractured bone segments. If the fracture does not involve the knee joint, rods and plates can be used to stabilize the fracture. For a fracture involving the knee joint, a bone graft may be required to prevent the knee joint from collapsing. An external fixator is used when the surrounding soft tissue is severely damaged, as the use of plate and screw may be harmful.

As the tibial fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long-term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.

What is a Thighbone Fracture?

The thighbone or femur is the longest and strongest bone in the body, connecting the hip to the knee. A femur fracture is a break in the femur.

Types of Thighbone Fractures

• Distal femur fracture: The distal femur is the lower part of the thighbone which flares out like an upside-down funnel. A distal femur fracture is a break in thighbone that occurs just above your knee joint. The lower end of the distal femur is covered by a smooth, slippery articular cartilage that protects and cushions the bone during movement. Fracture of the distal femur may involve the cartilaginous surface of the knee as well and result in arthritis.
• Femoral shaft fracture: A femoral shaft fracture is a break that occurs anywhere along the femoral shaft, long, straight part of the femur.
• Proximal femur fracture: A hip fracture or proximal femur fracture is a break in the proximal end of the thighbone near the hip.

Causes of Thighbone Fractures

Femur fractures may be caused by high energy injuries such as a fall from height or a motor vehicle accident. Patients with osteoporosis, bone tumor or infections, or a history of knee replacement are more prone to femur fractures. In the elderly, even a simple fall from a standing position may result in a fracture as the bones tend to become weak and fragile with advancing age.

Symptoms of Thighbone Fractures

Sudden, severe pain along with swelling and bruising are the predominant symptoms of femur fracture. The site is tender to touch with a visible physical deformity and shortening of the leg.

Diagnosis of Thighbone Fractures

The diagnosis of femur fracture is based on the patient’s medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate the soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.

Treatment for Thighbone Fractures

The management of the fracture is based on the severity of the fracture, medical condition of the patient and the patient’s lifestyle.

Non-surgical Treatment for Thighbone Fractures

Non-surgical treatment comprises of immobilizing the fractured site with the help of casts or braces to prevent weight bearing and to help the healing process. X-rays are taken at regular intervals to assess the healing process. Weight-bearing and movement are initiated gradually, depending on the nature of the injury and the condition of the patient.

Surgical Treatment for Thighbone Fractures

Surgical treatment is considered to realign the fractured bone. The use of advanced technology and special materials has improved the surgical outcome even in older patients. External or internal fixation or a knee replacement may be required depending on the extent of the fracture. Timing of the surgery is an important factor in improving the surgical outcome.

Timing of surgery

In most cases, the surgery is delayed for a few days to develop an effective treatment plan and for preparation of the patient. With most distal femur fractures the surgery can be delayed unless the fracture is open to the environment.

External fixator

An external fixator is used when the surrounding soft tissue is severely damaged, as the use of plates and screws may be harmful. The external fixator maintains the alignment of the bone till surgery.

Once the patient is prepared for surgery, the surgeon removes the external fixator and places internal fixation devices into the bone during surgery.

Internal fixator

The internal fixation may be performed using intramedullary nailing or plates and screws. In intramedullary nailing a metal rod is inserted into the marrow canal of the femur to keep the fractured fragment in position. In the plate and screw method the bone fragments are realigned and held together with screws and plates, attached to the outer surface of the bone. If the fracture is of the comminuted type or the bone has broken into many pieces, plates or rods may be used at the ends of the fracture without disturbing the smaller pieces. The plate or rod will maintain the shape or strength of the bone till it heals. In elderly patients and those with poor bone quality, bone grafting may be used to improve the healing. Knee replacement may also be considered in complicated fractures or those with poor bone quality.

Knee replacement

Artificial implants may be used to replace the fractured segments of the bone and joint.

Rehabilitation following a Thighbone Fracture

Rehabilitation following a femur fracture depends upon several factors such as age, general health of the patient and the type of fracture. As the femur fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long-term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.