The femur is the longest, heaviest, and strongest bone in the body, forming the thigh between the hip and knee joints. Its head, neck, and greater and lesser trochanters are clinically critical for hip fracture assessment, particularly in elderly individuals.
| Articulations |
|
|---|---|
| Landmarks |
|
| Ossification | Primary centre at 7 weeks fetal. Distal epiphysis present at birth (term marker). Head (6 months), greater trochanter (4 years), lesser trochanter (14 years), all fusing at skeletal maturity. |
The longest, heaviest bone in the body. Hip fractures (femoral neck and intertrochanteric) in the elderly carry 20 to 30 percent one-year mortality. Femoral neck fractures disrupt the retinacular blood supply, risking AVN, Garden classification grades displacement and AVN risk. Femoral shaft fractures require significant force and are treated with intramedullary nailing. Distal femur fractures involving the articular surface require CT planning and anatomical fixation. Stress fractures of the femoral neck medial cortex are high-risk fractures requiring prophylactic pinning to prevent complete displaced fracture.
Femoral neck and intertrochanteric fractures in older adults after falls carry high morbidity and mortality and usually need urgent surgery.
A high-energy injury causing a shortened, deformed thigh with substantial blood loss, usually treated with an intramedullary nail.
Repetitive loading in runners and military recruits produces stress fractures, most importantly on the tension side of the femoral neck.
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