Femur Injuries and Fractures Follow-up

Updated: Oct 01, 2015
  • Author: Nicholas M Romeo, DO; Chief Editor: Sherwin SW Ho, MD  more...
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Follow-up

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In cases of traumatic femur fractures, schedule a clinic follow-up visit at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. The femur fracture should be healed by 3 months. Once bony union is complete, treatment is focused on muscle rehabilitation. Progressive strengthening of all lower extremity musculature is initiated and continued until strength is 95% of the contralateral extremity. [34]

Sports-specific rehabilitation is initiated once strength has been regained. The athlete should be back to preinjury status at 1 year postinjury.

For femoral stress fractures, a minimum time of 6 weeks is necessary for bone healing to occur before the patient is able to resume full activity. The athlete should resume activities in a very gradual fashion over the course of several weeks. If symptoms recur during training, the athlete should return to the previous phase of treatment for a minimum of 3 weeks.

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Complications

Complications associated with traumatic femoral fractures include the following:

  • Nonunion
  • Delayed union
  • Malunion
  • Infection
  • Venous thromboembolic event (i.e., deep venous thrombosis or pulmonary embolism)
  • Pain
  • Ambulatory dysfunction
  • Refracture
  • Hardware failure
  • Prominent hardware
  • Neurologic injury
  • Peroneal nerve palsy - Most commonly due to traction
  • Pudendal nerve injury - Due to compression at the perineal post
  • Sciatic nerve injury
  • Vascular injury
  • False aneurysm
  • Atrioventricular fistula
  • Compartment syndrome

Complications associated with femoral stress fractures include the following:

  • Progression to a complete fracture
  • Refracture
  • Nonunion
  • Osteonecrosis
  • Arthritis
  • Continued pain
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Prevention

Stress fractures of the femur can be prevented or minimized by proper training techniques. Gradual increase in activity intensity and duration allow the body to respond to the increase load stresses. Maintaining proper footwear and not allowing footwear to break down, adequate rest periods in training, and good nutrition are also important aspects of prevention.

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Prognosis

Long-term symptoms after fracture include muscular weakness, limited standing and walking, gait abnormalities, some intermittent pain, and inability to return to preinjury work.

Surgical management is rarely needed to treat femoral stress fractures; however, surgical stabilization is recommended for recalcitrant cases.

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