Nutrient Artery Canal of Femur Masquerading a Fracture Line: A Case Report

Radiographic differentiation between true fracture lines and anatomical structures, such as nutrient artery canals, is crucial for optimal fracture management and postoperative mobilization. We present the case of a 54-year-old male with an AO 31A1.3 (AO/OTA 2018) pertrochanteric femur fracture treated with short trochanteric femoral nailing. Postoperative radiographs revealed an oblique radiolucent line adjacent to the distal part of the nail, raising suspicion of an undisplaced distal fracture extension. However, contralateral femoral imaging and CT scan confirmed the finding to be a nutrient artery canal. The patient was safely mobilized with full weight-bearing without the need for implant revision. Awareness of the radiographic features of nutrient artery canals is essential to avoid misinterpretation, unnecessary surgical modifications, and unwarranted delays in rehabilitation following fracture fixation.