Age

18–100

Sex

ALL

Healthy volunteers

Not accepted

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

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

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