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Updated: Aug 3, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Intraoperative Dysrhythmias Cease After Venting During Intramedullary Nailing of an Impending Femur Fracture: A Case
Frank A Martinez1, Evan M Dugdale2, Charles R Sims3
1Department of Orthopaedic Surgery, Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
Case:
A 76-year-old woman with multiple myeloma and osteoporosis presented with right hip pain and an impending atypical femoral fracture in the setting of chronic bisphosphonate use. After preoperative medical optimization, she was scheduled for prophylactic intramedullary nail fixation. Intraoperatively, the patient experienced episodes of severe bradycardia and asystole associated with intramedullary reaming, which ceased after distal venting of the femur. No additional intraoperative or postoperative complications were encountered, and the patient recovered uneventfully.
Conclusion:
Femoral canal venting may be an appropriate intervention for similar transient dysrhythmias caused by intramedullary reaming.
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