Femur fracture

This page is for adult patients. For pediatric patients, see: femur fracture (peds)


  • Despite good care, proximal fracture 30-day all cause mortality is 22% and grows to 36% at one year[1]

Femur Fracture Types



Clinical Features

  • History of trauma
  • Pain, point tenderness, deformity

Differential Diagnosis

Hip pain

Acute Trauma




  • Consider AP pelvis in addition to AP/lateral views to compare contralateral side
  • Consider MRI if strong clinical suspicion but negative x-ray


  • Plain xrays of femur


General Fracture Management

Specific Management

  • Pain control in ED with femoral nerve block

  • Type and cross/screen for patients at higher risk of hemorrhage:
    • Age > 75 yrs
    • Initial hemoglobin < 12
    • Peritrochanteric fracture


  • Generally requires admission for operative repair

Specialty Care

  • Most fractures, including all displaced, are treated with ORIF
    • Exception is isolated trochanteric fracture often does not require surgery
    • See individual pages for further discussion

See Also

  • Fractures (Main)


  1. Lawrence, VA, et al. Medical complications and outcomes after hip fracture repair. Arch Intern Med. 2002; 162(18):2053-7.
  2. Reavley P, et al. Randomised trial of the fascia iliaca block versus the ‘3-in-1’ block for femoral neck fractures in the emergency department. Emerg Med J. 2014 Nov 27.
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