A 17-year-old male professional motocross athlete with a history of pediatric left tibial shaft fractures (treated nonoperatively and complicated by painless varus malunion) presented to the ED after crashing his dirt bike. He had been wearing a hard-shell, hinged, knee brace measuring approximately 42 cm in length when he fell on his left side and hyperextended his left leg over the top of his knee brace. The patient complained of isolated left thigh pain. Evaluation of the patient revealed a closed, neurovascularly intact transverse femoral shaft fracture without ecchymosis, skin changes, or open wounds. The deformity was approximately 27.0 cm from the tibial tuberosity on clinical exam and measured 21.1 cm proximal to the center of the knee on AP radiograph (Figure 2). His baseline tibial deformity was unchanged. Again per institutional protocol, thin-slice CT pelvis was obtained to assess for associated femoral neck fracture, and this was negative. The patient was taken to the operating room (OR) the next morning and was treated with an anterograde femoral reconstruction nail with cephalomedullary screws. He received routine perioperative antibiotic prophylaxis, unrestricted postoperative weightbearing, and one month of chemical DVT prophylaxis. At one-year postoperative follow-up, the patient had regained full function and had returned to motocross at his preinjury level.