This article was co-authored by Janice Litza, MD. Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

There are 9 references cited in this article, which can be found at the bottom of the page.

A broken femur can be an extremely painful and inconvenient occurrence. Because the femur bone is so crucial to walking and moving through your daily life, breaking it is often quite demoralizing. If you have broken your femur, there are few things you can do to get yourself on the road to recovery, starting with surgery. Once surgery has been completed, you can manage your pain with medication, ensure proper healing at home, rehab your leg with physical therapy, and prevent future injury.

Understand the different phases of surgical treatment and recovery. 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.

Be aware of when surgery will occur. 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.

Look into internal fixation. 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.

Investigate external fixation to promote healing. 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.

Consider intra-medullary nailing to stabilize the area. 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.

Use NSAIDS to reduce inflammation. NSAIDS contain analgesic, anti-inflammatory as well as antipyretic properties. These drugs act upon certain body chemicals to prevent the progress of inflammation during injuries.

Health care practitioners do not encourage intake of this drug for the first 48 hours of injury, to let the body follow its natural course of healing.

The most commonly prescribed drugs to manage pain and swelling includes Celecoxib (Celebrex), Ibuprofen (Advil), and Naproxen (Aleve).

Request prescription painkillers if the pain of your broken leg is intolerable. In the case of a broken femur, pain can be severe and NSAIDS and other light pain medications are often insufficient. During consultation, healthcare providers generally address pain and inflammation. Prescription drugs, such as stronger painkillers, can be given to ease the sensation of pain and lessen the degree of inflammation.

Examples of prescription painkillers are codeine and tramadol.

These painkillers are only prescribed if simple painkillers do not reach the desired level of pain reduction.

Stronger types of painkillers must be taken at their proper dosage to avoid addiction and dependence.

Consider using antibiotics. Antibiotics may be necessary to avoid infection. Especially in the case of open femoral fracture and directly after surgery, antibiotics may be used to prevent infection of the site. The physician will first obtain a wound culture by getting a sample of wound discharge and getting it analyzed.

If an infection is found, the physician will prescribe the right antibiotic.

Open femoral fractures may occur from trauma cause by skin opening in the wound area.

Change the bandage incision daily to monitor it and refresh it. Change the bandage on a daily basis in order to expose the incision site to air and allow it to heal. Make sure that the wound looks healthy, and is not suffering from infection.

Watch out for the presence of redness, excessive drainage and unnecessary opening of the wound.

Inform your health care team of your injury. Let your primary care physician and your dentist know that there are rods and pins in your leg. This will allow your doctor and dentist to take any possible metal in your system into consideration when they are treating you for other ailments.

Note that antibiotics should be taken before any kind of dental work is done, to reduce the risk of infection.

Antibiotics are a prophylactic therapy done for as long as pins and rods are inside your body.

Lower your bed to allow for easy access. The bed where you sleep in should be low enough to allow your feet to touch the floor. This will not only allow you to get in and out of bed without straining your femur, it also helps to prevent falls and other accidents from occurring.

Set up your living area to accommodate you. Make sure that your house and frequented areas are set up to give you easy access and prevent falls. Also, make sure hazards are clear from trafficked areas in order to avoid accidents.

Remove loose cords, wires, and rugs from the areas where you usually walk.

Do not keep small animals because you might accidentally step on them.

Protect yourself from extreme heat to prevent bleeding. Individuals are advised to avoid contact with high temperatures such as hot baths, saunas and heat packs, because these can dilate blood vessels and increase incidents of bleeding. Although heat may feel good at first, it's potentially damaging effects need to be avoided.

Immobilize the limb. Stability of the femur must be maintained to prevent additional damage to the area and its surrounding tissues. Immobilization can be achieved by putting a splint and bandage on the affected area. Extreme activities and the application of too much pressure in the injured area should also be avoided to prevent further damage to the affected area.

Avoid massage and other manipulation of the affected area until healing is complete.

Apply a cold compress to reduce the risk of bleeding and swelling. Cold compress can usually be placed over the injured area to promote constriction of blood vessels that reduces the risk of bleeding and swelling. Compression also aids in stimulating the flow of lymph fluid, which carries important nutrients to the damaged tissues surrounding the injury.

Lymph fluid also removes waste from cells and body tissues which are an important part of the tissue regeneration process. [1]XResearch source(Hansen, K., 2013, June 6)

Elevate the affected limb to aid in circulation. The injured area should be kept elevated above the heart level. This action aids in proper blood circulation by promoting good venous blood return. Because the action of the veins is to return blood to the heart, elevating the injured area will allow gravity to aid venous blood return.

Try physical therapy to regain your strength after surgery. Individuals suffering from a broken femur are encouraged to try exercises that may aid in strengthening the femur and restore its normal function. These exercises can be utilized to divert sensations of pain and regulate proper circulation of blood to different parts of the body, including the affected parts around the femur.

You should discuss the suitability of all exercises with your physical therapist before trying them.

Generally, the following exercises must be performed 3 times a day, provided that they do not contribute to increased pain:

Know that exercise will help the healing process. Exercise and muscle movement promotes good blood circulation and oxygen distribution to the affected area. This will speed up the repair of the damaged tissue around the femur. This is because oxygen is essential for maintaining cellular integrity, function, and repair when tissues are injured. [2]XResearch source(Youn, B., 2000/2001)

Most femoral fractures take four to six months to completely heal.

Even with proper treatment, the length of recovery will depend on the severity of the fracture and the presence of other injuries to the body.

Strengthen your bones. Eat foods that are rich in calcium such as green leafy vegetables and make it a habit to regularly drink milk. Consume vitamin D supplements to help strengthen your bones. This will ensure that you do not re-break your femur.

Wear protective equipment. Especially if you are training for a big event, wear protective equipment to ensure that you do not break a bone. Also, make sure that you take short breaks in between your training period to help your bones recover from the pressure, strain and exhaustion.

Consider cross training. Do not overtrain because it can cause too much strain on the femur and your other bones as well. Alternate exercises so that your bones have a period to rest. You can alternate running with non-impact activities such as cycling and swimming.

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Community Q&A

Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

It's best to let it heal by keeping clean and dry and avoid sun exposure to the fresh skin. Sometimes putting Vitamin E oil or Aquaphor can help with healing and itching from the scabs. Antibiotic and hydrogen peroxide are not recommended.

Putting a hot water bottle feels good on my 3-month-old femur break with metal plate insert, but could the heat on my leg be worsening the problem, as the x-rays seem to indicate?

Community Answer

Not likely, since heat promotes blood flow while cold restricts it. The more blood flow, the faster the healing, but it is a possibility that since heat also relaxes muscles and maybe the break is at the point where it needs your muscles to tighten around it to help align it the way it once was.

Yes. See a doctor. If you have been to a doctor and know it is fractured, schedule check ups maybe once a month or more if necessary. If you are speculating the fracture and have not seen a doctor, then by all means see one asap.

They stopped my pain medications today after 4 weeks. Still in a lot of pain. Is this average stop date?

Community Answer

I've had two major surgeries in the past nine months on my distal femur and each time I was given 4 week prescriptions for pain meds. I used Tylenol arthritis after 4 weeks with success. Opiates are very addictive, so it's important not to take them for longer than strictly necessary.

About This Article

This article was co-authored by Janice Litza, MD. Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

To treat a broken femur, start by seeing a doctor immediately for evaluation, since surgery is usually necessary for this injury. After working out a treatment plan with your doctor, do your best to stay comfortable before and after the surgery. Over-the-counter medications like ibuprofen and naproxen can help with swelling, and your doctor will probably give you a prescription for stronger painkillers. Make your living space as accessible as possible and get started with physical therapy as soon as you can. To learn about the different types of femur surgery, read on!

Thanks to all authors for creating a page that has been read 98,800 times.

Reader Success Stories

Tracy McDonald

Jul 16, 2017

"I fell and have a femoral neck fracture, and did not know that I also have osteoporosis. I am only 48 years old, but had a hysterectomy when I was 29. I am 10 weeks post-surgery - still in pain and still no weight bearing. Doc told me it was at least a 12-week recovery for weight bearing to start. I go for a check up at the 12-week mark. This is the best info I have seen on the web, explaining everything. Thanks."..." more

Rated this article:

BA

Barbara Amdur

Mar 4, 2018

"I fell at home and broke my femur 5 weeks ago. I'm 89 years old, but I found your article extremely helpful---with a lot more explanation of the surgical procedures than my surgeon offered! In addition, the suggestions for cold packs and elevating the leg as much as possible were also very useful."..." more

JS

Joan Stephens

Jun 16, 2019

"Helped to explain what my sister will need to do when she is discharged from hospital after broken femur and hip replacement surgeries. Also helped to explain the surgery."..." more

KD

Kay Daly

Nov 18, 2017

"It helped me with exercises that I can continue with after surgery. I have just had replacement surgery of the rod in my femur."..." more

SH

Samuel Hayward

Jun 27, 2016

"The entire article was fully detailed and had step-by-step instructions for recovery."

DW

David Wills

Jan 29, 2017

"Useful tips and information as I embark on the road to recovery, thank you!"

"I fell and have a femoral neck fracture, and did not know that I also have osteoporosis. I am only 48 years old, but had a hysterectomy when I was 29. I am 10 weeks post-surgery - still in pain and still no weight bearing. Doc told me it was at least a 12-week recovery for weight bearing to start. I go for a check up at the 12-week mark. This is the best info I have seen on the web, explaining everything. Thanks."..." more

Rated this article:

BA

Barbara Amdur

Mar 4, 2018

"I fell at home and broke my femur 5 weeks ago. I'm 89 years old, but I found your article extremely helpful---with a lot more explanation of the surgical procedures than my surgeon offered! In addition, the suggestions for cold packs and elevating the leg as much as possible were also very useful."..." more

JS

Joan Stephens

Jun 16, 2019

"Helped to explain what my sister will need to do when she is discharged from hospital after broken femur and hip replacement surgeries. Also helped to explain the surgery."..." more

KD

Kay Daly

Nov 18, 2017

"It helped me with exercises that I can continue with after surgery. I have just had replacement surgery of the rod in my femur."..." more

SH

Samuel Hayward

Jun 27, 2016

"The entire article was fully detailed and had step-by-step instructions for recovery."