Abstract: Objective　To investigate the effects of closed reduction anterograde locking intramedullary nailing in the treatment of femoral shaft fractures with digital 3D model virtual surgical scheme.　Methods　From January 2013 to December 2016, 80 cases of femoral shaft fractures were treated with closed reduction and anterograde interlocking intramedullary nail. They were randomly divided into two groups: a treatment group and a control group. The treatment group underwent three-dimensional digital reconstruction of CT images, simulated the operation process, determined the selection of instruments and the location of nailing, and operated according to the virtual simulation scheme. The control group was given routine examination and surgical treatment. The operation time, X-ray time, intraoperative bleeding volume and prognosis were observed and followed up.　Results　There were statistical difference in the operation time and X-ray irradiation time of the treatment group from those in the control group, but there was no significant difference in the amount of bleeding during the operation. All the incisions healed in the first stage without any complications such as infection. The follow-up period ranged from 16 to 38 months. All patients recovered completely without pain and abnormal gait, and resumed normal daily life and hip joint activities.　Conclusions　Preoperative 3D reconstruction and virtual surgery for femoral shaft fracture with intramedullary nailing can significantly guide the surgical process, it is valuable for clinic application.

Key words: Fracture of femoral shaft, 　Intramedullary nail, 　Virtual surgery, 　Three-dimensional digital model