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A total of 73 consecutive intramedullary femoral nails were inserted for metastatic disease of the femur; 43 were reamed and 30 were solid nails. The two groups were similar with regards to age, type of primary tumour, anatomical site, acute or 'impending' fracture and postoperative survival. The 'solid' nail offers a satisfactory alternative form of stabilisation for metastatic disease of the femur with rates of implant failure which are comparable with the reamed nail. In this series bilateral nailing was not associated with any increase in mortality. Contrary to other reports, imposing a delay in patients with pain and a short life expectancy seems unjustified. The use of the 'solid' femoral nail does not prevent sudden death due to massive fat embolism.

Original publication




Journal article



Publication Date





25 - 31


Adolescent, Adult, Aged, Aged, 80 and over, Bone Nails, Embolism, Fat, Female, Femoral Neoplasms, Fracture Fixation, Intramedullary, Fractures, Spontaneous, Humans, Male, Middle Aged, Palliative Care, Postoperative Complications