Miss-a-nail Technique of Femur Neck Fracture with Femur Interlocking Nail in Situ: A Technical Description

Introduction: The neck of the femur fracture is more prevalent in the elderly, but can occur in young individuals due to high-energy trauma. Management of neck femur fracture with the femur interlocking nail in situ is a technically demanding case. Case Report: A 24-year-old male with a femoral neck fracture in the presence of an in-situ femoral interlocking nail was successfully managed using the MISS-A-NAIL technique. The goal of the management was an anatomical reduction of the neck of the femur fracture without removing the in situ femur interlocking nail, getting a stable hold and fixation with the cannulated compression screw without getting in the way of the interlocking femur nail, and using a minimally invasive technique with only a 3–4 cm incision. Conclusion: By providing a less invasive alternative to the traditional approach of removing interlocking nail and then fixing the neck of femur fracture, “Miss a nail technique” addresses the limitations of functional compromise associated with blood loss, neck of femur fracture displacement, iatrogenic fracture of the shaft femur, infections, and intra op complications related to nail removal. Keywords: Neck of femur fracture, intramedullary nail, cannulated screw.