This 50-year-old man fractured his femur at age 20, and the bone was fixed at the time, at another institution, with a small plate. The position was crooked and led to excessive wear on the inner side of the knee from malalignment. This is analogous to driving your car on unbalanced tires (left image).
ICLL physicians straightened the crooked femur with an intramedullary rod, using the fixator-assisted nailing technique (right image).