ABSTRACT
Associated hip fractures are treated differently than in younger patient where priority is towards preservation of blood supply of the femoral head. Femoral nailing can be performed supine, with or without a traction table, or in a lateral position. Plating for femoral shaft fracture has undergone a paradigm shift with better understanding of soft tissue biology, diaphyseal bone healing and the biomechanics of diaphy-seal plating. Periprosthetic femoral fractures have been shown to be increasing with the increasing number of hip and knee arthroplasties in an active elderly cohort worldwide. More recent literature detailing the use of locked plates in femoral diaphyseal fractures tends to involve subtrochanteric fractures, distal femoral fractures or periprosthetic and peri-implant fractures. The management of femoral shaft fractures in the elderly with osteoporotic bone is challenging. Data on timing of surgery, morbidity and mortality and overall benefit from surgery remain scarce.
