Article: There are three phases of surgical treatment – acute, recovery and maintenance.  The first priority when it comes to surgery is to rule out any other life threatening injuries and to stabilize the affected area.  Acute Phase – surgical stabilization is necessary at this point as well as the restoration of limb alignment.  Traction is administered for initial stabilization to take place. Inter-medullary nailing is the treatment of choice. Recovery Phase – the goal here is to encourage immediate weight bearing tolerance, improvement of hip and knee range of motion, and strengthening of the affected area.  Gait training and crutch use is done in this phase.  Low extremity aerobic training such as biking, swimming, and the use of an elliptical trainer is necessary for as long as it is tolerated. Maintenance Phase - in this phase, weight bearing is permitted once complete healing has been achieved.  Activities that can be done here include 30 to 45 minutes of bike riding in a flat surface.  Walking for 3 to 5 miles (4.8 to 8.0 km) per week is also encouraged. Running can be done after 3 weeks then gradual return to usual training regimen. After surgery, physical therapy, discussed below, is needed in order to gradually restore function to the thighs. Usually, range of motion exercises and stretches are done to give strength to the broken femur.  Gradual increase in physical activity is also considered. If you are suffering from closed femoral fracture, the surgeon will wait until you become stable before conducting the surgery. However, for open fracture, an emergency surgery is done immediately to prevent infection. Surgery for a broken femur can last up to three or four hours. Internal fixation is the choice surgery done to treat a broken femur. In this type of surgery, a cut is made to open the fracture, then internal fixator or special metal devices are used to hold the bone in place. Afterwards, a rod or a large nail is placed in the center of the femur to support the bone until it heals.  Sometimes a plate is also placed next to the bone which is attached using screws in order to frame the outside of the leg. Metal plates and screws will reduce the risk of further complications from occurring due to displacement. For external fixation, the surgeon will cut an opening to surgically place metal pins and screws into the bone above and below the fracture site. The pins and screws are attached to a bar outside the skin. This bar holds the bones together, when the skin and muscles have been injured, to promote healing. Pins are generally used when joints are not involved. During intramedullary nailing, metal rods are inserted into the marrow canal of the bones through a small incision. They are then screwed to the bone at both ends. This procedure keeps the bone in its correct position during healing. This surgery provides strong, stable and full-length fixation.
What is a summary of what this article is about?
Understand the different phases of surgical treatment and recovery. Be aware of when surgery will occur. Look into internal fixation. Investigate external fixation to promote healing. Consider intra-medullary nailing to stabilize the area.