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
Diagnosis of an impending femur fracture requiring prophylactic intramedullary fixation
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