title: Expert tibia nail for subtrochanteric femoral fracture to prevent thermal injury.
abstract: BACKGROUND
  Subtrochanteric femoral fractures are relatively uncommon, accounting for 7-15% of all hip fractures and treatment of these fractures are considered challenge for orthopaedic surgeons. Although several treatment options are reported with up to 90% of satisfactory results, the choice of the appropriate implant is still a matter of debate. Some authors reported thermal injury after reaming for intramedullary nail fixation in patients with narrow medullary canal.
  
  
  METHODS
  A 21-year-old female patient was admitted to our hospital because of right subtrochanteric femoral fracture. The narrowest diameter of medullary canal of her femur was about 7mm but she refused open reduction and internal fixation with plate due to large scar formation. We used expert tibia nail instead of femoral intramedullary nail to prevent thermal injury.
  
  
  CONCLUSIONS
  Subtrochanteric femoral fractures are difficult to treat because of their biomechanical and anatomical characteristics. Although several implants are reported for the surgical treatment of these fractures, intramedullary nails have been advocated due to their biological and biomechanical advantages. However, under certain circumstances with associated injury or anatomic difference we might consider another treatment options.
  
  
  CONCLUSIONS
  Expert tibia nail may be considered one of the treatment options for subtrochanteric femoral fracture with narrow medullary canal. We also emphasize the importance of preoperative evaluation of the medullary canal size for these risky fractures.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea; Pain Research Center, School of Medicine, Keimyung University, Daegu, Republic of Korea. Electronic address: oslee@dsmc.or.kr.
authors.forename: Kyung-Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Min
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea.
authors.forename: Mi-Kyung
authors.initials: MK
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Keimyung University, Daegu, Republic of Korea.
authors.forename: Min-Ji
authors.initials: MJ
authors.lastname: Kim
keywords: Bone marrow; Expert tibia nail; Intramedullary nailing; Subtrochanteric femoreal fracture
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