Figure 3

Preoperative anterior, posterior, and lateral x-ray image of the injured hip fixed with INTERTAN™ nail resulted in an iatrogenic fracture then fixed with a long and short INTERTAN™ nail to fix the iatrogenic fracture. (A) Preoperative anteroposterior X-ray image of the injured hip. (B) Preoperative lateral X-ray image of the injured hip. From the preoperative radiographs, the width of the proximal femoral canal was measured at around 11mm. (C) We did not expect there would be difficulties in the implantation of 10mm-diameter INTERTAN™ nail during the preoperative measurement of the femoral medullary cavity. After routine proximal canal reaming, we implanted the main pin manually and encountered resistance. We then hammered the main pin into the ideal position and performed the remaining steps. When the final X-ray was taken to confirm the position, an iatrogenic fracture of the distal femur was observed. The original short TRIGEN INTERTAN nail and the captured locking screw were removed (arrow). Subsequently, a longer INTERTAN™ nail was implanted to fix the iatrogenic fracture.