by AceMedEd

Teach card · keep it in your scrub pocket

Femoral shaft fracture

Ask during the case

  1. Positioning and the start point: "Show me the piriformis fossa and the tip of the greater trochanter on this AP shot. Which is our entry for this nail, and where should the guidewire sit on the lateral?"
  2. After the wire crosses the fracture, before locking: "How will we check length and rotation against the other leg, and what will the lesser trochanter and the cortices at the fracture tell us?"
  3. Before the drapes come down: "What do we look for on the femoral neck now, and what do we examine on the knee while the patient is still asleep?"

Point at: the femoral neck on the fluoroscopy screen before the drapes come down, while they say what an ipsilateral neck fracture would look like.

End of day: "Draw me the mid-thigh cross-section, then an AP femur with both entry points." Two minutes each, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

The night before. They prep alone, redraw at turnover, and get a cold check tomorrow morning. They won't see these questions.

Open the student page

Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures, with Rockwood and Green for fractures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.