Overview
A Fracture in the thigh bone (femur) will be severely painful and may be swollen or bruised. A child will be unable to walk on the leg. There may have been a “crack” sound when the leg was broken, and the shock and pain of breaking the leg may cause your child to feel faint, dizzy or sick.
What to Do
If you think a child has broken their femur, go immediately to your nearest accident and emergency (A&E) department. Call 999 for an ambulance if the injury seems severe or you’re not able to get to A&E quickly.
While you make your way to A&E or wait for an ambulance:
- avoid moving the injured leg as much as possible – keep it straight and put a cushion or clothing underneath to support it
- don’t try to realign any bones that are out of place
- cover any open wounds with a sterile dressing, a clean cloth or a clean item of clothing – maintain direct pressure on the wound if it keeps bleeding
- KEEP THE CHILD FASTING (No food or Drink)
- Where possible try to get someone else to drive so you can support and comfort your child en route to the hospital.
On arrival in the emergency department the child will be given pain relief and typically a nerve block (local anaesthetic around the nerve) to take the pain away from their leg. They will be placed in a Thomas Splint to realign the fracture. They may require medication to relax the muscles of the leg to help with their pain also.
For children under 5 years old this splint is usually kept on for a 7-10 days before being changed to a ‘Spica Cast’.
Children over 5 years old who have a suitable fracture pattern maybe offered surgical fixation of the fracture in appropriate circumstances.
Care Advice During Recovery
You’ll be given advice by your doctor about how much your child should move the leg and when and how much weight they can put on it. Tip – If the doctor tells you they can put only half their weight on the injured leg, then use bathroom scales to test their weight. Start by gently pressing down until the scales reach half of their current weight.
It takes around 6 to 8 weeks for a minor fracture to heal. While more severe fractures can take 3 months or more to fully heal. If a spica cast has been applied it is removed at the 6-8 week stage. Follow-up at the fracture clinic will typical continue until the medical team are satisfied the fracture has healed and there is no evidence of injury to the growth plate.
Your child may require crutches or a wheelchair during this time, until it’s possible to put weight on the leg again. You’ll be shown how to safely use any mobility equipment you’re provided with.
The hospital may recommend regular physiotherapy appointments to help you maintain or regain muscle strength, movement and flexibility. This will include specific exercises to do before and after the cast is removed. Don’t try to rush the recovery by returning to your normal activities too quickly, as the broken bone may not be fully healed even when the pain has gone.
Follow the advice of your doctor, who’ll probably recommend gradually increasing how much you use your leg over time. Please seek advice from your doctor about when it is safe to return to sport and other higher risk activities like gymnastics or cycling etc.