Femoral shaft fractures (FSF) are common in orthopedics, mostly due to high-energy injuries. Due to its anatomical peculiarities, most of the fractures are significantly displaced, and complications such as deformed healing, bone non-union, fat embolism and acute respiratory distress syndrome often occur if not treated properly. This article mainly introduces the research progress of internal fixation of femoral shaft fractures in adults, in order to provide reference for clinical practice.