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Femur fractures - DRHC Dubai Fracture Clinic

Proximal femur fractures are rare injuries that occur in the upper part of the femur bone. They are mainly caused by high-energy trauma, such as falls from a great height or car accidents, and in rare cases, due to pathological fractures (cysts, tumors).

It can be associated with other conditions like

  • Head trauma
  • Abdominal trauma
  • Spleen rupture
  • Pelvic fracture
  • Pelvic hemorrhage
  • Retro peritoneal hemorrhage 
  • Femur fracture ipsilateral or contralateral 

Usually, we see this fracture in children 2-3 years old and that is probably from non-accidental etiology and in the adolescent population involved in motor vehicle accidents.

The proximal femur contains proximal femoral epiphysis where the bone grows about 3mm per year and at the end of growth, it will be responsible for about 15% of overall leg length.

Symptoms and Diagnosis

Patients with a proximal femur fracture present with severe pain at the hip and an inability to bear weight on the affected leg. In cases of displaced fractures, there is a deformity in the extremity, with the lower extremity appearing shorter and externally rotated.

A plain X-ray is normally sufficient for diagnosis. However, in some cases, a CT scan or MRI may be needed to detect non-displaced fractures, stress fractures, or pathological fractures.

Treatment Options

Treatment for proximal femur fractures depends on the type and extent of the fracture:

  • Non-Operative Treatment: This is usually indicated for non-displaced or minimally displaced fractures common in children less than 4 years old. The treatment involves closed reduction and Spica abduction casting.
  • Operative Treatment: This is the main treatment for proximal femur fractures and is done either by closed reduction and percutaneous pinning or by open reduction and pin or screw fixation.


The major complications of proximal femur fractures are avascular necrosis to the femur head inside the hip joint, which can lead to osteoarthritis in the hip joint, and premature physeal closure, which can lead to shortness in the femur.

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