The pelvis and femur are two of the strongest bones in the body, and the muscles surrounding this area are also extremely strong. Some of the more familiar muscles around the hip joint and femur are the quadriceps muscle in the front (flexes the hip and straightens the knee), and the hamstrings in the back (straightens hip and flexes the knee). Other important muscles for the hip include the gluteal muscles (buttocks) that move the hip out to the side (abduction), and the iliopsoas muscle that is one of the main hip flexors.
Acute femur injuries
Femur (shaft) fractures
Femur fractures are very common in children. The treatment is based upon the age and size of your child, as well as the location of the fracture.
If your child is four years old or younger, your doctor will likely recommend a cast for treatment. This cast is called a spica cast—it begins in middle of the chest, extends the entire length of the fractured limb, and then the entire length or half the length of the other limb.
Spica casts are applied in the operating room with your child completely asleep to prevent any discomfort and so the surgeon can properly fit the large cast. Your child can usually be discharged from the hospital and go home the same day. It may be necessary to make some modifications like adding straps to your car seat and possibly using a wheel chair if your child is too big to fit in a stroller. Our team will help you with equipment prior to being discharged from the hospital.
For a femur fracture, children typically stay in the spica cast for a total of six weeks. Once the cast is removed, your child may experience:
- Stiffness and perceived pain
- Inability to walk for a few days to a few weeks
- Walking with a limp for a few months
- Rash on the skin where the cast was removed
For children age 5 and older, the treatment of the femur fracture is more dependent on the location of the fracture and the size of the child. We often insert flexible rods into the femur bone near the knee to line up the broken ends of the femur fracture. The surgery is minimally invasive and most children recover quickly. Your child will need another surgery to remove the rods, usually nine to 12 months after the injury.
Other times, a plate is used to fix the fracture, or a rod may run the length of the femur bone.
Femur physis (growth plate) fractures
Fractures can occur in either the distal (bottom) physis or the proximal (top) physis and are rare. The top growth plate is located between the head and neck of the femur bone. The concern with this type of fracture is a permanent loss of blood supply to the hip joint that can result in avascular necrosis (bone tissue death).
Fractures to the bottom growth plate require a great amount of force to occur, such as direct blow from a soccer collision, football tackle or getting hit by a car. The main concern is permanent growth problems and the risk increases with the severity of injury. Approximately 50 percent of children may suffer from some type of growth problems as a result of this injury. If only a portion continues to grow, there can be a difference in limb length when your child is fully grown, and the bones could be crooked.