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The IM pin that is protruding from the gluteal region is tied in with a type 1 ESF frame applied on the lateral side of the femur. The pin counteracts the bending forces and the external fixator protects the fracture from collapse, shearing and torsional forces.

Note: This will be a less rigid stabilization than a bone plate. It is important to assess the ability of this type of stabilization to counteract all the forces that will be placed on it. Safe zone ESF pin placement is difficult in the femur because of the large muscle mass on the lateral surface. In addition, the intramedullary pin will cause interference with the gluteal muscles.