• Juan Castellanos, Laura Garcia-Nuño, Jose María Cavanilles-Walker, and Jaume Roca.
• Department of Orthopedic Surgery and Traumatology, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain. 20744jcr@comb.es.
• Eur J Trauma Emerg S. 2009 Oct 1;35(5):479-81.

BackgroundIntramedullary nails have become a popular implant in the management of femoral shaft fractures. The occurrence of a femoral neck fracture after closed intramedullary nailing is an exceptional complication of this technique that has been rarely reported in the literature.MethodsWe report a retrospective study to identify the possible causes that could produce a fracture of the femoral neck after nailing of the ipsilateral femur.ResultsA total of four neck fractures were identified in a series of 494 femoral shaft nailing, all of them not visible on the initial plain films. In two cases, the nail entry point was located lateral to the tip of the greater trochanter. In the other two cases, the entry point was located too medial to the greater trochanter, violating the superoexternal cortex of the femoral neck.ConclusionThe event of a femoral neck fracture during closed intramedullary nailing is an unusual complication that may be caused due to a technical mistake related to the location of the nail entry portal in the proximal femur.

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