Arnold Besselaar, Daniel Green, Andrew Howard
Femoral fractures are often high-energy injuries and are associated with significant but predictable complications.
Treatment related complications can be minimized by anticipating them and paying attention to the general principles of fracture management.
Delayed union and nonunion are rare in femoral shaft fractures due to excellent muscle coverage.
Refracture is uncommon with intramedullary fixation.
Factors contributing to delayed union and nonunion also increase the risk of refracture.
Consider reevaluation of leg length after one year when most of the effect of overgrowth will be apparent.
Clinical assessment of leg length uses a tape measure from the ASIS to the medial malleolus.
In a long-leg x-ray the leg length is measured between the radiographical landmarks femoral head and ankle joint.