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The need to immobilize the femur is primarily due to fractures and dislocations. Each of these injuries dictates a specific immobilization and stabilization technique. In the acute phase of the injury, application of external devices may facilitate transportation and other treatment necessities of the polytrauma patient. The most common cause of the 2 injuries is trauma which may cause an open or closed fracture, but both can typically be immobilized with the same principles. Later in the course of the treatment, other stabilization options are available. This activity reviews femur immobilization management, and explains the role of the interprofessional team in providing care for patients who require femur immobilization. Objectives: Identify the indications, and contraindications of femur immobilization. Describe the equipment and personnel needed for femur immobilization. Review the potential complications of femur immobilization. Explain the role of the interprofessional team in providing care for patients who require femur immobilization. Access free multiple choice questions on this topic.

The need to immobilize the femur is primarily due to fractures and dislocations. Each of these injuries dictates a specific immobilization and stabilization technique. In the acute phase of the injury, application of external devices may facilitate transportation and other treatment necessities of the polytrauma patient. The most common cause of the 2 injuries is trauma which may cause an open or closed fracture, but both can typically be immobilized with the same principles. Later in the course of the treatment, other stabilization options are available.

Improper placement of a splint may cause complications due to the straps or parts of the rigid structure of the splint causing local injuries. Once immobilization has been achieved, continually test distal circulation, sensation, and motor. Perform frequent interval reevaluation of the neurovascular status as changes often occur in the acute phase of the injury as swelling increases. Complications most commonly occur in relation to one of these areas. Swelling may also cause local and distal complications, and the patient should be frequently evaluated for compartment syndrome. Transfemoral/transtibial pins may have a localized infection or bleeding. Routine pin site care should address these to prevent these potential complications.[4][8]

The team caring for patients with a femur injury requiring immobilization includes pre-hospital, emergency department, and inpatient teams. Each of these teams needs to reevaluate the need, placement, and effectiveness of the immobilization if placed by a previous team. Some immobilization devices and techniques may suit the needs of these teams, but change may be necessary according to the needs of a new team and environment. When transferring care, teams should include communication about the immobilization and any deficits observed before placing the immobilization device. Handoff is a source of significant risk in relation to patient harm if the appropriate information is not clearly communicated to the new team.[9][10] (Level V and III) Each team is responsible for evaluating and reevaluating any device placed on a patient. When placing an external device on the lower extremity, an initial evaluation of circulation motor and neurologic is necessary. If a team member notices a deficiency or abnormality, this should be communicated immediately to the physician caring for the patient. This may indicate a critical condition, and the physician should direct care, which may be to adjust the immobilization device, ordering tests, or changing the timeline for definitive treatment. Other specialists may need to be involved based on the clinical findings. These cases often involve trauma surgery, vascular surgery, and neurosurgery or once another diagnosis has been discovered these specialists may become involved.