Posttraumatic axis deviations and pseudarthroses are frequent complications following femur fractures. In addition to varus/valgus and ante/recurvation deformities, rotational changes and length deviations may occur. Combined axis deviations are particularly frequent after comminuted diaphyseal fractures. In the context of corrective osteotomy, both internal and external osteosynthetic methods are available. Osteotomy by means of oscillating saw and osteosynthesis by means of angled blades plates are still considered "classic techniques" in the proximal and distal femur; intramedullary nail fixation is more commonly used in the diaphyseal region. Regardless of the method or implant chosen, such multi-dimensional corrections are often very demanding surgical procedures. In contrast to many of the internal methods, external osteosynthetic procedures offer the potential to extend an extremity, as well as other postoperative corrective possibilities. It must be borne in mind, however, that these can lead to extended treatments times and complications, such as pin track infections.