A and B, Anteroposterior and lateral radiographs of proximal femur of 61-year-old man with multiple myeloma show multiple lytic lesions. C and D, CT better shows extent of lesions and need for prophylactic fixation. E and F, Preoperative embolization was done to minimize intraoperative blood loss, which can be extensive with multiple myeloma. G and H, Radiographs after prophylactic fixation with long gamma nail. I, Typical microscopic appearance of multiple myeloma with sheets of plasma cells.