الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Femoral shaft fractures are severe injuries that quickly draw physicians’ attention and are often associated with other fractures.
Ipsilateral knee ligament injuries may also be associated with such factures, and most of these are diagnosed at a late stage.
Recognition of ligamentous injuries of the knee in the acute phase is essential for optimum treatment and prognosis. A multi traumatized patient with a fractured femur and occult knee ligament damage presents a difficult diagnostic challenge.
Ruptured ligaments are difficult to be identified during the initial evaluation because the classical physical signs of ligamentous injury may be obscured due to swelling and muscle spasm attributed to the associated fracture.
One should have a high index of suspicion about internal knee ligamentous injuries while dealing with high-energy femoral shaft fractures and awake patient with associated knee pain in particular.
Evaluation of acute knee injuries, the gold standard is physical examination in association with magnetic resonance analysis. In our study, magnetic resonance imaging is difficult to obtain, which has made physical examination under anesthesia fundamentally important for the diagnosis.
In our study, we prospectively study patients (39 male and 5 female) with femoral shaft fracture that had been admitted to Menoufia University Hospital. All cases that fulfilled the inclusion criteria after femoral fixation with intramedullary rod placement, external fixation, or plate fixation underwent a thorough physical