A 2015 Cochrane review 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. Open fractures must undergo urgent surgery to clean and repair them, but closed fractures can be maintained until the patient is stable and ready for surgery. Skeletal traction Available evidence suggests that treatment depends on the part of the femur that is fractured. Traction may be useful for<unk>  shaft fractures because it counteracts the force of the muscle pulling the two separated parts together, and thus may decrease bleeding and pain. Traction should not be used in<unk>  neck fractures or when there is any other trauma to the leg or pelvis. It is typically only a temporary measure used before surgery. It only considered definitive treatment for patients with significant comorbidities that contraindicate surgical management. External fixators External fixators can be used to prevent further damage to the leg until the patient is stable enough for surgery. It is most commonly used as a temporary measure. However, for some select cases it may be used as an alternative to intramedullary nailing for definitive treatment. Intramedullary nailing For<unk>  shaft fractures, reduction and intramedullary nailing is currently recommended. The bone is re-aligned, then a metal rod is placed into the<unk>  bone marrow, and secured with nails at either end. This method offers less exposure, a 98–99% union rate, lower infection rates (1–2%) and less muscular scarring. Rehabilitation After surgery, the patient should be offered physiotherapy and try to walk as soon as possible, and then every day after that to maximise their chances of a good recovery.
Femoral fracture
Pelvic fracture
Hip fracture
Knee dislocation  Knee dislocation  1
Humerus fracture
Elbow fracture
Ankle fracture
Hume fracture