why does a fracture of the neck of femur produce external rotation of femur?

[sarah_med]

Hi i'm just wondering why a fracture of neck of femur produces external(lateral) rotaion and shortening of the femur? I have an idea, but i'm not completely sure. An answer would greatly be appreciated. Sarah

[wicksee]

Hi,
I fractured the top of my right femur (just below the neck) 20 years ago; I was 14 years old at the time. I was in traction for 8 weeks before being discharged, no metal bars or casts were used.

The bone healed well but I now seem to be suffering from rotation of the bone. My right foot points outwards by about 10-20 degrees further than my left foot. I have a collapsed foot arch, and running for more than 10 mins can make the inside of my knee painful. I also suffer from groin strains on my right side. When I step off the ball of my right foot when walking, the foot kind of twists and my heel turns inwards. This causes the sole of my right shoe to wear quickly.

Could these symptoms be a result of femur rotation? If so, what can i possibly do about it? I have tried to point my foot inwards when walking but it feels uncomfortable.

[Elik19]

It is due to the pull of the psoas originating from T12-L4 of the vertbral column which inserts on to the lesser trochanter of the femoral head. The fracture of the surgical neck results in the psoas and ilacus muscle having no restriction to lateral rotation and flexion due to the positions of the muscles origin and insertion. Hope this helps

[PuchiLePup]

Can confirm this is the correct answer. UK Med student

[JainMD]

Hi,
How are you feeling now?
I think you need re-evaluation regarding the metal plates in your joint.
Can you tell us which part of femur is fractured and whether you got operated with plate insertion?
I think if inward rotation of knee joint is a recent event; then you can take help by applying brace at your knee joint.
Has any imaging study being done? If yes, what is the report like?
Have you consulted any physiotherapist?
I think active physiotherapy would help you in achieving the range of motion around the joint and can actually decrease your inward rotation at knee joint.
Keep me informed if you have any queries.
Bye.

[starzlp]

I fractured my femur and I'm wondering if there is anything I can do to improve my rotation. My knee turns to far inward, so my ROM is affected in that I can't sit indian style and can over extend my leg outward.  Also It's been a few years and I'm wondering what the adavntage is to have the metal bar removed?

[pootz620]

my theory to that is that the hip's loose pack position(comfortable position with less pain and less impact from the femoral head to the acetabulum-socket)  is external rotation, flexion and abduction.  once the fracture happens, the body automatically produces that "defense mechanism" to it's comfortable position.  as opposed, the close pack position is internal rotation,extension, and adduction in which the body avoids that position.  the shortening of the femur will greatly depend on the type of fracture whether it's impacted or just a breakage.  Gluteus maximus primary motion is extension.  it has to do with your hip flexors, external rotators, and abductors.  the capsule plays a major role in it's open and closed packed position. i hope this helps..if you want read a kinesiology book about the hip by norkin and levangie.

[sarah_med]

?

[sarah_med]

Does the gluteus maximus play a part in the external rotation aswell or is it just the joint capsule and it's seperation?or both? Thanks a lot for your help :)

[sonu78]

Hi,
In case of fracture of the neck of femur, the attachment of the joint capsule on to the distal fragment of the femur is separated. This separation of attachment causes the distal fragment to move upwards and forwards. This is the reason for the external rotation of the limb and shortening of the limb.

[Godofredo MD]

Hi.

Basically, the rotation results from the change in the axis of the limb owing to the separation of the body and head of the femur.

Hope this answers your query.