Injuries associated with a fractured shaft of the femur.

A knowledge of injury patterns, both from the mechanism of injury and from their associations, allows specific injuries to be suspected and actively excluded. We have reviewed fractures of the femoral shaft to highlight the patterns of their associated high morbidity and mortality. Our survey shows that accidents involving motorcyclists, pedestrians and motor cars have the highest incidence of associated injury. Common associations include chest, head, pelvis and ipsilateral leg injuries in pedestrians, and pelvic and ipsilateral leg injuries in motorcyclists. Rarer associations with femoral shaft fractures include ipsilateral tibia and talus/navicular fractures in motorcyclists, knee injuries and contralateral acetabular fractures in pedestrians and contralateral necks of femur in motor car passengers.