PMC2637254_01
Anteroposterior (AP) view radiograph of the left femur demonstrating the large lytic metastasis in the subtronchanteric area.
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F1
However detailed radiological evaluation demonstrated a large lytic lesion in this case (Figure 1).
AP and lateral image intensifier views showing optimal positioning of the proximal locking screws and the intramedullary nail in the left proximal femur.
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F2
Due to the high risk of an impending pathological fracture, the decision was taken to perform prophylactic intramedullary nailing of the left femur (Figure 2).
AP views of the left distal femur demonstrating drilling and creation of a distal venting hole.
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F3
In order to reduce the increased intramedullary pressure during nail insertion, venting of the distal end of the femur was performed (Figure 3).