Effect of a Femoral Venting Hole on Embolic Load in Prophylactic Intramedullary Nailing

Effect of a Femoral Venting Hole on Embolic Load in Prophylactic Intramedullary Nailing: A Feasibility Study

The purpose of this study is to measure intraoperative embolic burden during prophylactic intramedullary nailing of impending femur fractures in patients treated with versus without venting, to find the association between embolic burden and intraoperative physiologic changes, measured using standard anesthesia monitors and charted data, to measure Immediate and short-term cardiopulmonary outcomes assessed during hospitalization and to assess procedure-related complications associated with venting

Inclusion Criteria:

• Diagnosis of an impending femur fracture requiring prophylactic intramedullary fixation

• Impending fracture secondary to a pathologic process, including:

  • Long-term bisphosphonate use, or
  • Oncologic disease without radiographic evidence of cortical disruption

• Ability to provide informed consent

Exclusion Criteria:

• Inability to obtain adequate intraoperative transthoracic echocardiography (TTE) imaging windows for visualization of right-sided cardiac structures
• Inability to tolerate or safely undergo TTE monitoring per anesthesia determination
• Any intraoperative technical limitation preventing reliable echocardiographic data acquisition