They are typically sustained in high-impact trauma, such as car crashes, due to the large amount of force needed to break the bone.

These types of fracture cause more damage to the surrounding tissue, are less likely to heal properly, and are at much greater risk of infection.

[citation needed] Femoral shaft fractures can be classified with the Winquist and Hansen classification, which is based on the amount of comminution.

[7] A 2015 Cochrane review (updated in 2022) found that available evidence for treatment options of distal femur fractures is insufficient to inform clinical practice and that there is a priority for a high-quality trial to be undertaken.

Traction may be useful for femoral shaft fractures because it counteracts the force of the muscle pulling the two separated parts together, and thus may decrease bleeding and pain.

[19] Since femoral shaft fractures are associated with violent trauma, there are many adverse outcomes, including fat embolism, acute respiratory distress syndrome (ARDS), multisystem organ failure, and shock associated with severe blood loss.

[citation needed] Femoral shaft fractures occur in a bimodal distribution, whereby they are most commonly seen in males age 15-24 (due to high energy trauma) and females aged 75 or older (pathologic fractures due to osteoporosis, low-energy falls).