Femoral shaft #
Femoral shaft
B/L
| Column 1 |
Column 2 |
Column 3 |
Column 4 |
|
Hemodynamically ; unstable |
Hemodynamically ; stable |
|
| Pulmonary contusion |
Ex Fix |
Nail one; Plate/exfix other |
Good oxygenation |
| Pulmonary contusion |
Ex Fix |
Ex Fix |
Poor oxygenation |
| No Pulmonary contusion |
Ex Fix |
B/L nail |
Good oxygenation |
Polytrauma
- Delay beyond 12 hours reduce mortality by 50% (Morshed et al JBJS 2009)
Shaft with neck
- Open shaft: deal with it as per BOAST guideline, then NOF
- If shaft closed: NOF first then Shaft
- Retrograde nail and screws
Hip disclocation with shaft
- Relocate hip first from Theatre
- If not getting reduced, shanz pins connected by rod used to reduce
- if not getting open
- Posterior: Posterior
- Anterior: SP
Written/reviewed by Kishore Puthezhath
Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon
FRCS (Tr & Orth) revision resource
Reviewed: September 2026