ABSTRACT
The femur is the largest bone in the human skeleton. Its inherent strength means that fractures of the shaft are usually associated with high-energy trauma. However, an aging osteoporotic population is leading to a significant increase in fragility fractures. Additionally, modern arthroplasty of both hip and knee involves the femur, and the trend for increasing periprosthetic fractures continues. However, femoral shaft fracture does carry potential for occult bleeding of up to 750 mL, which can contribute to hypovolaemic shock. Patients are reviewed 10 days following surgery to check wounds; regular radiological follow-up is required to monitor fracture healing. Patients are reviewed 10 days following surgery to check wounds; regular radiological follow-up is required to monitor fracture healing. Historical non-operative treatment was associated with high rates of malunion and knee stiffness. The increasing use of total hip replacement combined with an aging, osteoporotic population has led to a challenging increase in periprosthetic fractures since the early 2000s.
