Fig. 2

Failed nailing of an intertrochanteric fracture in an active 78-year-old man. a The intertrochanteric fracture had been stabilized by an antegrade long γ nail and circumferential cerclage 4 years ago. The patient first experienced significant hip pain and restricted hip motion 1 month ago without trauma history. Radiography showed nonunion of the intertrochanteric fracture and breakage of the γ nail. b Transverse and c coronal sections of CT scans showed osteolysis of the great trochanter as well as coxa vara with obvious fracture gaps. d Prior implants were removed. The malalignment was corrected, causing a larger gap in the calcar. Sufficient bone grafting was used to fill the gap, and the fracture was stabilized by a reverse LISS for the distal femur