Mid-Shaft Femur Fracture in a 22-Year-Old Woman at 20 Weeks of Gestation: A Case Report on Multi-Disciplinary Management

Minish Katkar, Shraddha Walse, Samiksha Dhama

Abstract: Background: Femoral shaft fractures in pregnancy are uncommon and present unique challenges related to maternal physiology, fetal safety, and ionizing radiation exposure during operative fixation. The embryo and fetus are sensitive to ionizing radiation at doses greater than 0.1 Gy, although non-cancer health effects are not detectable below this threshold at any stage post-conception (1). Case presentation: We report the case of a 22-year-old primigravida at 20 weeks of gestation who sustained a closed mid-shaft femur fracture following RTA. She underwent closed reduction and intramedullary nailing under image-intensifier guidance using a structured radiation-minimization protocol, including abdominal lead shielding, pulsed fluoroscopy, last-image-hold, and supervision by a senior surgeon. Obstetric monitoring confirmed fetal wellbeing throughout. Postoperatively she received thromboprophylaxis and an early, progressive mobilization program. Conclusion: With a multidisciplinary approach and adherence to the ALARA (as low as reasonably achievable) principle, operative stabilization of a femoral shaft fracture can be performed in pregnancy with an estimated fetal radiation dose far below thresholds associated with adverse effects, and with favorable maternal and fetal outcomes. Early restoration of mobility aligned with pregnancy-specific physical activity guidance supported a healthy remainder of the pregnancy.

Keywords: femur fracture; pregnancy; fluoroscopy; radiation exposure; intramedullary nailing; ALARA

How to Cite?: Minish Katkar, Shraddha Walse, Samiksha Dhama, "Mid-Shaft Femur Fracture in a 22-Year-Old Woman at 20 Weeks of Gestation: A Case Report on Multi-Disciplinary Management", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1094-1098, https://www.ijsr.net/getabstract.php?paperid=MR26918021351, DOI: https://dx.doi.org/10.21275/MR26918021351

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