Background: Femur is the most fractured long bone in the body that often necessitates surgical fixation; however, data on the impact of the mechanism of injury (MOI), age, and timing of intervention are lacking in our region of the Arab Middle East. We aimed to describe the patterns, management, and outcome of traumatic femoral shaft fractures. Methods: A retrospective descriptive observational study was conducted for all trauma patients admitted with femoral shaft fractures between January 2012 and December 2015 at the only level 1 trauma center and tertiary hospital in the country. Data were analyzed and compared according to the time to intervention (intramedullary nailing; IMN), MOI, and age groups. Main outcomes included in-hospital complications and mortality. Results: A total of 605 hospitalized cases with femur fractures were reviewed. The mean age was 30.7 ± 16.2 years. The majority of fractures were unilateral (96.7%) and 91% were closed fractures. Three-fourths of fractures were treated by reamed intramedullary nailing (rIMN), antegrade in 80%. The pyriform fossa nails were used in 71.6% while trochanteric entry nails were used in 28.4%. Forty-five (8.9%) fractures were treated with an external fixator, 37 (6.1%) had conservative management. Traffic-related injuries occurred more in patients aged 14–30 years, whereas fall-related injuries were significantly higher in patients aged 31–59. Thirty-one patients (7.8%) had rIMN in less than 6 h post-injury, 106 (25.5%) had rIMN after 6–12 h and 267 (66.8%) had rIMN after more than 12 h. The implant type, duration of surgery, DVT prophylaxis, in-hospital complications, and mortality were comparable among the three treatment groups. Conclusions: In our center, the frequency of femoral fracture was 11%, and it mainly affected severely injured young males due to traffic-related collisions or falls. Further multicenter studies are needed to set a consensus for an appropriate management of femur fracture based on the MOI, location, and timing of injury.

Avulsion fractures of the anterior inferior iliac spine are uncommon and such injuries are caused by the sudden forceful contraction of the straight head of rectus femoris muscle while the hip is hyperextended and the knee is flexed. This case report describes the condition of 17 year old male footballer who complained of pain in the right groin for duration of 2 years after being involved in forceful sport activity. Detailed history, clinical examination, X-rays and CT scan revealed hypertrophic malunion of avulsion fracture of anterior inferior iliac spine causing an extra-articular type of femoroacetabular impingement. The patient was surgically treated when conservative management was unsuccessful. This is the first case of hypertrophic malunion of avulsion fracture of anterior inferior iliac spine with femoroacetabular impingement that has been recognized in Qatar. The patient was surgically treated in order to relieve symptoms and avoid osteoarthritis. Malunited avulsion fracture of anterior inferior iliac spine can cause extra-articular femoroacetabular impingement.