My son is in the hospital for a badly broken ankle. I overheard the nurse saying there were four other kids in the unit — all with femoral shaft fractures. What’s that and what causes it?

The femur is your thigh bone. It’s the longest bone in the body. The main part of the bone (between the top and bottom) is referred to as the shaft. Femoral shaft fractures occur most often in the middle third of the shaft as a result of a fall or car accident.

In younger children (12 and under), the car accident is more likely a pedestrian-vehicle accident (in other words, they got hit by a car). Older children with this type of fracture are more likely to have come by the injury as a result of a car accident in which they were passengers in the vehicle.

Most of the time, this type of injury requires surgery. This is especially true if the bone is displaced. A displaced bone fracture is one in which the broken pieces have separated and/or moved apart. Sometimes the fracture is comminuted, which means there are many tiny bone pieces at the site of the fracture.

The surgeon reduces the fracture by lining up the two ends of the broken bones and holding them in place until healing takes place. The process of holding the bones together is called fixation.

There are many ways to accomplish fixation including metal plates and screws, pins attached to an external frame. The frame is on the outside of the body. The pins go through the skin and into the bone and secure the bone to the frame. Sometimes it’s necessary to use traction first to pull the bones apart and then apply the fixation device.

Each child is treated according to the location, type, and severity of the fracture. The surgeon tries to avoid disrupting the growth plate in any child who has not stopped growing yet. And every effort is made to prevent a limb-length difference.