case_images: PMC2637254_01
case_images: Anteroposterior (AP) view radiograph of the left femur demonstrating the large lytic metastasis in the subtronchanteric area.
case_images: 1757-1626-2-12-1.jpg
case_images: PMC2637254_01_1757-1626-2-12-1.jpg
case_images: F1
case_images: However detailed radiological evaluation demonstrated a large lytic lesion in this case (Figure 1).
case_images: AP and lateral image intensifier views showing optimal positioning of the proximal locking screws and the intramedullary nail in the left proximal femur.
case_images: 1757-1626-2-12-2.jpg
case_images: PMC2637254_01_1757-1626-2-12-2.jpg
case_images: F2
case_images: 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).
case_images: AP views of the left distal femur demonstrating drilling and creation of a distal venting hole.
case_images: 1757-1626-2-12-3.jpg
case_images: PMC2637254_01_1757-1626-2-12-3.jpg
case_images: F3
case_images: In order to reduce the increased intramedullary pressure during nail insertion, venting of the distal end of the femur was performed (Figure 3).