Femur fractures are treated surgically in the majority of cases. Depending on the location and progression of the fracture, it is fixed with plates, screws or nails. Sometimes there is insufficient bone in the area. In this case, additional bone tissue, e.g. from the pelvic bones, will be grafted into the femur.
Femur fractures are divided into: Femoral head fractures, femoral neck fractures and femoral shaft fractures. Femur fractures are the most common type. Older people are typically affected by osteoporosis, e.g. after a fall on their side.
Metal plates, screws or nails are generally used for the surgical treatment of femur fractures. This method of fixing fractures with metal parts is called osteosynthesis.
What preparations are carried out before the procedure?
Before the operation, the exact position and the progression of the break are illustrated in the x-ray image.
All the usual pre-operative assessments are required, such as a blood test, blood pressure measurement and an ECG. The patient must stop taking blood-thinning medication and have an empty stomach for the procedure.
How is the operation performed?
The operation method that is used depends on the x-ray images as well as the general condition of the patient. It is usually performed on an outpatient basis. Depending on the situation, the procedure occurs under general anaesthesia or under spinal cord anaesthesia (spinal anaesthesia). The bone is then exposed in the area of the break. The broken femur is straightened and bone fracture fragments are fixed in the correct position with one another. In the process, metal plates, metal pins, dynamic hip screws or external fixation devices are used. When insufficient bone material is available to fix the break due to osteoporosis or an extensive comminuted fracture, bone tissue is taken from elsewhere, e.g. from the hip bone, and used in the femur. In the case of severe femoral head breaks or also femoral neck breaks, an artificial hip joint is used.
After fixing the fracture, a drainage tube is often inserted to drain the fluid from the wound. Finally, the operation wound is closed. Depending on the procedure, the operation takes 1 to 2 hours.
What is the success rate of this procedure?
The breaks are stabilised and the bones generally heal well with surgical treatment. Early mobilisation is important, particularly in the case of older people, so they do not lose the ability to walk.
What are the possible complications and risks of this procedure?
Operations on femur fractures are low-risk and usually proceed without any serious complications. As with all surgery, in exceptional cases the operation may lead to infections, nerve damage, post-operative haemorrhaging or blood clots. In rare cases, the patient can have limited movement in their hip joint. Older people run the risk of losing the ability to walk.
What happens after the operation?
Physiotherapy exercises are begun soon after the operation. The drainage tubes are removed after 1 to 2 days. Postoperative pain is treated with painkillers. During the hospital stay of approx. six weeks, the patient may put some weight on the leg with the help of crutches. They may not put their full weight on their leg until it has healed fully; this will take approx. 6 to 8 weeks. The healing process is monitored with regular follow-up checks.
The screws or plates used during the osteosynthesis are not usually removed as long as they do not cause any complaints.
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