Classic history and presentation: The condition presents as severe pain, swelling, and deformity of the affected thigh. Due to the trauma that frequently causes these fractures, soft tissue injury and bleeding are usually present and may lead to shock.
Prevalence: The estimated incidence of femoral shaft fractures is 9-22 fractures per 1000 people worldwide each year.
- Age – These fractures most commonly occur in the young (< 40 years) due to high-energy trauma (eg, MVAs), but incidence increases again in individuals older than 75 years due to low-energy trauma (eg, falls).
- Sex / gender – This condition can occur in either sex but is more common in young males.
- If younger than 40 years, high-energy trauma such as MVAs.
- If older than 75 years, low-energy trauma such as falls.
- Osteopenia or osteoporosis, general or localized.
- Long-term use of bisphosphonates can result in atypical femur fractures.
Classification system: There is no formal classification, but these injuries are described by location and fracture pattern. Location of the fracture is often described as proximal third, middle third, and distal third. Fracture patterns can be described as spiral, oblique, transverse, or multifragmentary. It should be noted if the fracture is open or closed.
An AO Foundation / Orthopaedic Trauma Association classification is available for research purposes only and is not used to describe injuries in the clinical setting.