Femoral shaft fractures are high-energy injuries, and intramedullary nailing is their reference treatment for a reason. A nail sits on the mechanical axis of the bone, shares load with the fracture rather than shielding it, and lets the patient load the leg early — the factors that make union fast and predictable in the shaft region.
The antegrade approach enters at the proximal femur and follows the canal distally, keeping the surgical insult away from the fracture site itself. Diameter is matched to the reamed canal, and locking screws secure rotation and length at both ends. Entry point selection, reaming strategy and locking configuration remain with the operating surgeon.