Treatments including physical manipulation maneuvers have been widely used for the management of various pain complaints. These maneuvers, although generally considered safe, can be associated with serious complications. We report the case of a 37-years-old previously healthy male patient, who presented to our emergency department (ED) for severe right thigh pain and inability to bear weight that developed during a chiropractic session. Imaging done at the ED showed a displaced distal femoral shaft fracture. The majority of the complications of manipulation maneuvers can be as simple as sprains, however, can be drastic or life-threatening in certain cases causing cerebrovascular accidents or major orthopedic fractures. Such complications are rare and definitely underreported. A femoral shaft fracture occurring as a result of physical manipulation has not been previously reported in the literature. We report a distal femoral shaft fracture that was induced by forceful chiropractic manipulation. It is the first to be reported in the literature. This complication should be noted, reported, and the necessary precautions are taken to avoid such major adverse events.
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