الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Fractures of the proximal femur are common injuries in adults. These fractures are associated with substantial morbidity and mortality.
Most proximal femoral fractures occur in elderly individuals as a result of moderate or minimal trauma. In younger patients, these fractures occur . anu usua\\)1 aSSOCla\eo wWn mu\tlp\e injuries. These fractures are, more than ever, an important challenge in the field of traumatology.
Several studies have evaluated whether use of an intramedullary nail would result in better outcomes than a sliding hip screw, thereby justifying its increased expense.
• The shorter lever arm of the intramedullary device decreases tensile strain on the implant, thereby decreasing the risk of implant failure.
• Maintenance of controlled fracture impaction as most intramedullary devices incorporates a sliding hip screw
• The intramedullary location limits the amount of sliding and therefore limb shortening and deformity.
• Insertion of an intramedullary nail requires shorter operative time and less soft-tissue dissection than a sliding hip screw, potentially resulting in decreased overall morbidit.
• An intramedullary nail can withstand the major muscle forces on the Subtrochanteric region in addition to the highest tension and compression forces occurring in this region.
Many authors advice the use of long nails to avoid stress fracture at the tip of the nail and to use well fitted diameters of the nail to enhance rapid healing. Failer of fixation with intramedullary fixation is rare and if occurred it can be treated with nail exchange to a larger diameter nail with static locking.