Failure of femoral nailing in the elderly

Failure of fixation of a fracture of the mid-shaft of the femur in a 73-year-old male occurred 4 weeks after insertion of a reamed Grosse-Kempf nail. The oblique locking screw had cut out, despite having been correctly sited at the primary operation. A satisfactory result was obtained following open nailing using an AO nail. Two transverse proximal locking screws provide more certain fixation in osteoporotic bone of elderly patients.