34 patients who experienced a multiple trauma injury with a femoral shaft fracture were included in this study. Patients were randomized to either damage control treatment where initial external fixation was performed followed by delayed intramedullary nailing once patients were stable or an immediate intramedullary nailing group. The study was conducted to determine whether the damage control method would reduce the occurrence of organ failure and other outcomes. Unfortunately, the trial was terminated before achieving the preplanned sample size of 140 due to poor recruitment. The findings indicated comparable rates of organ failure, transfusion requirements, acute respiratory distress syndrome, systematic inflammatory response syndrome and length of hospital stay between groups. Ventilation days and length of intensive care unit stay was significantly greater in the external fixation group.