Prophylactic stabilization of proximal femoral metastatic bone disease: reconstruction intramedullary nail fracture.

Pathological fracture is an unfortunate manifestation of metastatic bone disease and whenever possible, prophylactic stabilization is preferable to fixation of fracture. The Russell-Taylor reconstruction intramedullary nail (Smith & Nephew Richards, Inc., Memphis, Tennessee) provides a stable construct for the prophylactic management of impending pathological fracture. Implant failure with this system typically involves distal locking screws. Cases of proximal screw cut-out and pullout have been reported as has breakage of both proximal locking screws. We present a case of failure of the Russell-Taylor delta reconstruction nail implant, just distal to the point of insertion of the proximal locking screws.