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From the American Academy of Orthopaedic Surgeons

Femoral Shaft Fractures

by Thomas A. DeCoster, MD; Shahram Bozorgnia, MD; Fabio Caetano Soares de Figueiredo, MD

Patients with a femoral shaft fracture typically have sustained high-energy trauma, such as that which occurs in a motor vehicle accident. As such, femoral shaft fractures are severe and are associated with potentially life-threatening pulmonary and vascular complications. Fractures of the femoral diaphysis are commonly described by location and geometry of the fracture, degree of comminution, and severity of the soft-tissue injury. Associated injuries to other parts of the femur, other bones, and soft tissue are common.

This article reviews the pathophysiology and clinical presentation of femoral shaft fractures, and reviews the considerations for surgical and nonsurgical treatment. Specific surgical techniques reviewed in this article include a detailed, step-by-step video of the reamed, interlocking, rigid, retrograde intramedullary nailing procedure. An audio panel discussion on antegrade versus retrograde nailing is also featured.

Keywords: multiple femoral shaft fractures, ipsilateral fracture of the femoral and tibial shafts, ipsilateral femoral neck and shaft fractures, ipsilateral intertrochanteric and diaphyseal fractures of the femur, subtrochanteric femoral shaft fractures, intramedullary nailing, antegrade locked intramedullary nailing with reaming, static interlocking, antegrade locked intramedullary nailing without reaming, retrograde reamed nailing

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