This study is for patients that have suffered a femur fracture due to metastatic cancer. The standard of care for this type of fracture is to stabilize the bone with an intramedullary nail. When preparing the femur for the nail, pressure can cause fat to enter the bloodstream and travel to the heart, causing heart and lung complications. The procedure being investigated in this study is called reduced pressure reaming. In this procedure the surgeon will use a device with suction when preparing the bone for the nail in order to decrease pressure and decrease the amount of fat that enters the bloodstream. Patients will be randomly assigned to either the standard preparation (standard reaming), or the reduced pressure preparation (reduced pressure reaming). After surgery, both treatment groups will followed according to standard practices at 2 weeks, 6 weeks, 3 months, and 6 months.