The femur, or thigh bone, is the largest and also one of the strongest bones in the body. It forms both the hip and knee joints. Fractures can occur at any location along the bone, although factors like your child’s age, the fracture location, and alignment can all impact the treatment plan.
The femur requires a lot of energy to fracture, so these fractures typically occur as the result of accidents such as car crashes, contact sports or falls from a height. Any femur fracture in an infant or toddler who is not yet walking is concerning and may be a sign of child abuse. Occasionally, a femur fracture can heal in a shortened position or have some overgrowth while healing, so your doctor may suggest monitoring leg lengths for several years following the injury.
A fracture of the upper portion of the femur is considered a hip fracture and can be treated with a soft harness or brace in infants and toddlers. Older children and adolescents will likely require a hip spica cast or potentially surgery, depending on the location and severity of the fracture.
Femoral shaft fracture
A femoral shaft fracture is a break in the midportion of the bone. It is typically treated with a hip spica cast with or without closed reduction (setting the bone without surgery). In some cases, this type of fracture may require surgical correction using flexible nails, rigid nails or plates and screws. Older children or children with more severe fractures are more likely to require surgery due to the reduced potential for their body to naturally remodel and reshape the bone.
Distal femur fracture
These fractures occur just above the knee and frequently involve the growth plate in this area. These fractures can be treated in a long-leg cast, but if they involve the growth plate, your child’s doctor will need to monitor the leg in the future due to the potential for growth disturbance.
Examples of femur fractures