Pathological fracture after prophylactic reconstruction nailing of the femur : The need for distal locking

Reconstruction nails have become the treatment of choice for established or impending subtrochanteric fractures of the femur and distal locking is said not to be indicated if the isthmus is intact. We report a case where distal locking was not performed and a proximal fracture subsequently occurred. We believe that distal locking should always be carried out in impending subtrochanteric fractures which are treated by nailing.