Intramedullary bone pedestal formation contributing to femoral shaft fracture nonunion: A case report and review of the literature

Figure 5 Illustration of left femur intra-operatively. A: Showing femur after intramedullary nail removal. Guide rod tip still unable to pass distally in canal due to intramedullary bone pedestal; B: Showing starting reamer used to breach intramedullary bone pedestal; C: Showing new nail (solid lines) at area of wider, more distal meta-diaphyseal bone compared to old nail (dotted lines) at area of more proximal, narrow diaphyseal bone.