Clinical features

Painful thigh

Inability to move the thigh.

 Deformity. The proximal segment is most commonly pulled into flexion and external rotation by the psoas and abduction by the abductors. The distal fragment is drawn into varus by the adductors, into extension by the two heads of the gastrocnemius, and shortening by the extensor mechanism and hamstrings. 

Shortening of the limb in question

Instability of the thigh around the fracture site

In case of vascular injury

Features of shock. Estimated blood loss in closed femoral shaft fractures is 1000-1500ml.

Absence of pulse distal to the injury site.

In case of neural injury

Loss of sensation to touch, temperature and pain distal to the fracture site.