Abstract
73 years old femur who had right thigh soft tissue sarcoma and had neoadjuvant chemoradiation and scheduled for soft tissue wide resection and prophylactic femur nail in the presence of risks for post operative fracture. During surgery and after tumor wide resection and cephalomedullary nail placement that both went uneventful, noted to have longitudinal subtrochanteric fracture of about 5 cm extended from lag screw down. While the usual placement for nail through radiographic guided, we inserted our nail during open procedure after sarcoma wide resection and would not recognize the presence of fracture if still through minimal invasive radiographic guided. With that, I am raising the fact how many times we instrumented the femur with unknown sequences of sub-radiographic fracture? And what are the implications?
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