Presentation
Accidental fall from a height. Deformity of the right thigh.
Patient Data
Age: 3 years
Gender: Male
From the case:
Femoral shaft fracture
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AP radiograph shows a displaced proximal third femoral shaft fracture.
From the case:
Femoral shaft fracture
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Right proximal third femoral shaft fracture. With displacement:
- Red arrow: Abduction
- Blue arrow: External rotation
- Yellow arrow: Adduction and shortening of the distal fragment.
Case Discussion
This case illustrates the main deformities seen in proximal third femoral shaft fractures, a result of the unbalanced muscle pulls. Understanding these deforming forces is important when planning the treatment:
On the proximal fragment:
- Abduction: by the gluteus medius and gluteus minimus
- External rotation: by the action of the short external rotators
- Flexion: by the iliopsoas (Not seen here – Can be seen on a lateral projection)
On the distal fragment:
- Adduction and shortening: due to adductor muscles pull.