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This article presents the application of ultrasonography to assist femoral fracture reduction and nailing base on the original experience and literature review. This specific technique has been originally introduced as an alternative for doing a closed unlocking femoral nail in the condition lacking of image intensifier. Recently, decision making regarding choices of treatment in femoral fracture might be changed from the past decade and many factors related with those options needs to be more concerned. Therefore, readdress of this particular issue should be a benefit for future modification.