الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
roximal femoral fracture in the elderly remains a subject of great interest. This is because there have been recent devel-opments in regards to optimizing treatment and design of new prosthesis. Minimally invasive surgery has been shown to reduce operative blood loss, surgical time, pain, and hospital stay.(61)
Meta-analysis cannot answer the question whether intramedullary or extramedullary fixation should be preferred as it appears that the big advantage of immediate postoperative direct full weight-bearing after intramedullary fixation com¬pared to extramedullary fixation, is outweighed by the disadvantage of a higher number of early re-operations due to technical problems accompanying nailing.(66)
A study was conducted to compare all cephalocondylic intramedullary nail with extra-medullary implant for the surgical treatment of extracapsular hip fractures in adults and concluded that there is lower complication rate of the S.H.S. (sliding hip screw) in comparison with intra-medullary nails. S.H.S. is superior for trochanteric fracture (stable type) and intramedullary nail is preferred in case of subtrochanteric fracture and reverse oblique fracture.(36)
Proximal femoral nail has many advantages over others methods of fixation of unstable trochntric fracture such as providing high rotational stability and biomechanical stability, considered as minimal invasive procedure, patients operated by proximal femoral nail can be mobilized earlier .(46)
Many complications have been reported regarding proximal femoral nail such as non union of unstable trochantric fractures, mal union loss of proximal fixation femoral shaft fractures and z effect and reverse z effect.(95)