Inability to deploy the distal fixator fin of a Brooker-Wills nail

While a Brooker-Wills nail was being placed in an osteotomized femur during the course of a closed femoral shortening procedure, the slot holding the distal fixator fin was deformed as it was driven across the fracture/osteotomy site (approximately 50% apposition), and the fin could not have been deployed had it been needed for stabilization of the fracture. This case illustrates the importance of maintaining a meticulous closed reduction and of obtaining oblique image intensifier views of the distal portion of this nail while it is being inserted.