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The usual injury mechanism for femoral shaft fractures is severe direct force or an axial load to the flexed knee (typically in a motor vehicle crash or automobile-pedestrian collision). Thus, other serious injuries are often present. Fracture causes obvious swelling, deformity (often with shortening), and instability. Up to 1.5 L of blood for each fracture may be lost. Hemorrhagic shock is possible, particularly when the cause is blunt trauma and there are other injuries. Diagnosis of Femoral Shaft Fractures