Multi-apical femur deformities are generally caused by metabolical diseases and in order to achieve good alignment, multiple osteotomies are required. To stabilize femoral osteotomies, circular, unilateral external fixator (EF), fixator assisted intramedullar nailing (FAN) (fixator assisted nailing- FAN) and intramedullary (IM) nailing options can be used. Appropriate femoral alignment, healing and lengthening could be obtained using all the above techniques with similar outcome. On the other hand, there are some disadvantages when stabilising with EF such as longer treatment duration, pin-tract infections, recurrence of deformity after fixation, re-fracture and patients not feeling comfortable with it whereas in fixation with FAN techniques, despite longer learning curve, it is more preferable due to better stability, having less recurrence of deformity or re-fracture and possibly being more comfortable for the patients.