Proximal femoral nailing for intertrochanteric fracture combined with contralateral femoral neck local osteo-enhancement procedure (LOEP) for severe osteoporotic bone loss: An original Italian case series.

Proximal femoral fractures in elderly women are a major cause of morbidity and mortality worldwide and a public health concern. Although pharmacological therapies have shown potential in improving bone mineral density (BMD) and decreasing fracture risk, the current research effort is focused on developing a procedure that can ensure both immediate and long-term efficacy. A minimally-invasive surgical approach, known as AGN1 local osteo-enhancement procedure (LOEP), has been recently developed to promote bone augmentation. The procedure implies the preparation of an enhancement site, a specific location where new bone is required within a local bony area weakened by osteoporotic bone loss, and the insertion of a triphasic, resorbable, calcium-based implant material. The results of this procedure have shown a significant and sustainable long-term increase in the proximal femur BMD and consequently in bone strength, thereby improving the femoral neck's resistance to compression and distraction forces that may result in fall-related fractures. A preliminary case series of ten women, suffering from intertrochanteric fracture and contralateral proximal femur severe osteoporotic bone loss, who underwent a combined procedure of proximal femoral nailing and AGN1 local osteo-enhancement procedure, has been developed over the course of a year of clinical and radiological data collection.