Since I didn't have a big enough nail handy for this one, I used an old lag screw
. Just keep in mind you don't need or even want an extremely hard bolt.
In the treatment of TFs with proximal nailing, the most frequent complications are varus collapse of the proximal femur, cut-out of the lag screw
, shortening of the femur, nonunion, secondary fracture of the femur or greater trochanter, thigh pain, screw fracture, and Z-effect or reverse Z-effect of nails with two lag screws
Advantages of the DCS plate include the relative technical ease of the procedure, as well as the ability to compress the nonunion site through the large proximal lag screw
. Furthermore, at the author's institution, this plate is bent according to preoperative plans, allowing for improved contact throughout the lateral cortex after osteotomy completion .
However, poor fixation and loss of reduction may occur as a result of unsatisfactory control of the proximal fragment during insertion of the lag screw
The Gamma nail is susceptible to fail at its weakest point, the lag screw
implant interfaced [14,15,16,17,18]
The ideal position of the proximal lag screw
(PLS) within the femoral head to provide optimal stability to the implant-bone structure has not been studied sufficiently for cephalomedullary nails (9-11).
The students were introduced to the concept of Interfragmentary lag screw
fixation by Prof Zaki Idrees.
The TRIGEN INTERTAN Intertrochanteric Antegrade nail (Smith & Nephew, Memphis, TN) was introduced in 2005 and increases intertrochanteric rotational stability  and decreases lag screw
cutout [4, 5].
osteosynthesis a new procedure for treating fractures of the man-dibular angle.
Exclusion Criteria: Criteria for exclusion included intracapsular femoral neck fractures; intertrochanteric fractures in which the head-neck fragment has connection with the trochanter(s), or has inferior cortical extension which can tether it to a distal fragment and prevent its spinning around the lag screw
; and patients with advanced arthritis or with a pathological fracture.
(3,4) In the majority of described cases of hip fracture related vascular complication, the injured vessel is either a branch of the profunda femoris artery due to penetration by a drill bit or screw, or an intra-pelvic vessel damaged by over-penetration of the lag screw
The lag screw
or blade with a length of 100 mm, a long barrel 135[degrees] side plate, and four conventional bicortical screws were inserted as a complete set of fixation.