We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Mid-shaft femur fracture
From WikEM
(Redirected from Subtrochanteric femur fracture)
Includes all subtrochanteric femur fractures
Contents
Background
- Occurs with severe trauma or in association with pathologic bone
- Blood loss can be substantial (average loss = 1L)
Clinical Features
- Clinical presentation is similar to intertrochanteric fracture
- Affected leg is shortened and externally rotated
Differential Diagnosis
Femur fractures
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Evaluation
- 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
Management
- 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
- Sagar and Hare splints are commonly used by EMS providers
- Buck's traction used by ortho
- ORIF
Disposition
- Admit
See Also
External Links
Wheelers' Textbook - Femoral Shaft Fracture
References
- ↑ Agrawal Y, Karwa J, Shah N, et al. Traction splint: to use or not to use. J Perioper Pract. 2009; 19(9):295-298.
