By Matt Lalande in Personal Injury on September 14, 2019
As Hamilton personal injury lawyers that have represented victims since 2003, we have been lucky enough to learn a significant amount of anatomy over the years from some of Ontario’s best orthopedic surgeons who have helped us with our cases, provided us with medical opinions and testified for us in Court. For example, did you know that according to the American Physical Therapy Association, only 25% of individuals who suffer femur fractures are able to return to the same activity level they were experiencing prior to their injury?
The femur is the largest, longest, and strongest bone in the human body. The femur articulates with the both acetabulum (hip socket) to form the hip joint and below the tibia and patella to form the knee joint. It is comprised of two main components: the femur (thigh) and the femoral shaft. The femoral shaft is the part of the thigh bone that runs from below the hip (where the thigh is located) down to the wide part of the knee. Additionally, the area just above the knee joint is known as the distal femur.
There are many reasons and causes for femoral fractures, including old age, postmenopausal conditions, osteoporosis, decreased muscle mass and contact sports. Normally with persons with normal bone strength or without underlying conditions, the most common causes of femur fractures includes motor vehicle accidents and falls from a height. Motor vehicle accidents include car accidents, motorcycle accidents, pedestrians hit by cars and bicycle accidents.
Femur fractures are normally categorized by the exact location of fractures – or where the bone breaks. The first type is called a proximal femoral fracture, which is also sometimes called a hip fracture. This type of break involves the upper most portion of the femur bone adjacent to the hip joint. The second type is shaft fracture that generally occur in MVA or falls from a high enough level. The third type is distal femoral fractures, which is an injury to the thigh bone just above the knee joint. This fracture can involve the cartilage of the knee joint, which puts a person at risk of developing knee arthritis at some point in their life.
There are varying types of common femur fractures, such as:
Transverse fracture: When the break occurs straight across the bone.
Oblique fracture: When the break is at an angle across the bone.
Comminuted fracture: When the bone breaks into multiple pieces.
Open fracture: When pieces of the bone are sticking out of the skin, or when a wound is so deep that the bone is exposed.
Spiral fracture: When the break occurs in a spiral or circular pattern around the bone, generally caused by a twisting motion upon impact.
Open fractures are generally associated with the most damage to the body, particularly to the surrounding area of the femur fracture. Since the bone in this situation is protruding from the body, the risk of infection or other complications is much higher. This may require longer healing time and carries a higher risk of permanent or long-term disability.
Many femur fractures are reported to occur in relation to mostly pedestrians hit by cars. In fact, medical studies have shown that pedestrians that are hit by cars and trucks have the highest mortality and injury rates of all vehicle traumas. Several year ago, a well-known peer reviewed article in the Journal of Orthopedic Trauma reported on fractures patterns in relation to pedestrian hit by cars. Drs. Brainard, Slauterbek and Benjamin reported that femur fractures in pedestrian accident victims were the third most common fractures, behind tibia-fibula and pelvic fractures. Fractures of the femur were normally as result of a direct-blow mechanism – such as the bumper of the car against the leg. vehicle accidents could be caused by any variety of factors, including common examples of negligent driving such as:
In some cases, a lower impact incident, such as a slip and fall, may cause an individual to suffer from a femur fracture, but these cases are rare and generally only occur within the elderly or individuals with weaker bone structure. However, femur fractures are generally known as high-energy injuries.
Since the femur is the largest and strongest bone and takes a significant impact to cause damage, many femur fractures require surgery. Usually the orthopedic surgery involves inserting plates and screws in the thigh for the purpose of holding the bone in place and allowing it to heal. However, there are different methods of doing this that depend on the type of fracture and the severity of the injury.
We have learned that femur surgery is normally in two parts – one called an “open reduction” meaning that your orthopedic surgeon will make an incision to re-align the bone. The second part, an “internal fixation” means that the bones are held together with hardware like metal pins, plates, rods, or screws. After the bone heals, this hardware may or may not be removed.
It can take anywhere from an average of three to six months for an individual to heal from a femur fracture surgery. During that time, the individual is generally limited in their mobility. Scarring could be extensive depending on the type and location of the femur fracture and subsequent surgery. For some accident victims, the time frame could be longer if there are complications that arise during the healing process.
Fractures of the disatal femur (near the knee joint) may in fact heal with a defect in the normally smooth surface of the joint. Because your knee is the largest weightbearing joint in your body, any type of defect can no doubt damage your articular cartilage – which does not regenerate. Over time, the joint surface of the knee may wear down to bare bone on bone.
Arthritis that is normally caused by car accident related injury is called “post-traumatic arthritis”. Post-traumatic arthritis can be treated like other forms of osteoarthritis — with physical therapy, braces, medications, and lifestyle changes. in severe cases of post-traumatic arthritis, a total knee replacement may be the best option to relieve an accident victim’s symptoms.
If you have suffered a serious femur fracture, you may be entitled to pursue compensation against the at-fault party that caused you injuries. You may be entitled to file suit and seek compensation for your pain and suffering, loss of wages, housekeeping inefficiency, future medical costs outside of OHIP (i.e. for future surgery) , among other things. We would suggest booking a free, no-obligation consultation to discuss yourparticular situation. Call us at 905-333-8888 or through our online contact form to request your free consultation.
This is not, and please do not take this as medical advice. We are not doctors. We represent accident victims in Court. This post was written with information gained from our knowledge and conversation with some of Ontario’s best Orthopedic Surgeons, as well as varying medical journals and medical textbooks. IF you have a knee problem, it’s important for you to speak to a qualified medical professional.