Fig. 2. During insertion of an intramedullary nail's massive empennage, there is a distraction effect (V effect) on the trochanteric fragments, which increases the incidence of hip varus deformity or nonunion (A). With the assistant holding the proximal-medial part of basicervical fracture line in position (B), a reamer with high rotation speed can be used to enlarge the proximal femur; this diminishes the V effect and lag screw malposition (C).