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Pitfalls: eccentric and overaggressive reaming

Eccentric reaming
Eccentric reaming can cause weakening of the adjacent cortex, which may interfere with healing, or even cause a fatigue fracture.

Trapping of reamer by slow spinning
If the reamer gets trapped while reaming, it must be gently removed by the most senior surgeon because breakage of the reamer tip in this situation can be a devastating complication.

Heat necrosis by over-forceful reaming
Reaming with excessive force should be avoided because it is likely to cause heat necrosis of the femoral cortex. This applies especially for narrow midshaft canals (9 mm or less in diameter).