Shaft of Femur Fracture

A 32-year-old male presents to the emergency department following a high-speed motor vehicle collision. He has severe pain in the right thigh with gross swelling and deformity. On examination, the right lower limb is shortened and internally rotated. X-ray confirms a comminuted fracture of the right femoral shaft at the junction of middle and distal thirds. The patient is haemodynamically stable with no other major injuries. What is the most appropriate initial management for this fracture?

A 28-year-old woman is admitted 6 hours after a fall from a height with a closed fracture of the left femoral shaft. Intramedullary nailing is planned. During the procedure, the surgeon notes difficulty in obtaining anatomical reduction of the comminuted fragments. After successful nail insertion, post-operative X-rays show 12° of varus angulation and 8 mm of shortening. The patient develops fever (38.5°C) and tachycardia (110/min) on post-operative day 2, with no signs of surgical site infection. What is the most likely diagnosis?