[Intramedullary fixation and proximal femoral fractures: diversity in use through case reports].

Proximal femoral fractures, including intertrochanetric and subtrochanteric with diaphiseal propagation represent a significant challenge in orthopedic surgery, especially in older population. Retrospective analysis of patients, after the application of "Bi Nail (Bioimpianti Inc.) intramedullary nail for fractures and pathological conditions of proximal femur, was done at the Department of Adult Orthopedics, Institute of Orthopedic surgery Banjica, during the three year period. We present patients with complex fractures and pathological conditions (metastasis and pseudoarthrosis) of proximal femur; most of the fractures were result of effects of low energy, and the most common pathological fracture is due to metastasis of breast cancer. The analysis included the technical characteristics and duration of surgery, intraoperative and postoperative complications as well as the coalescence time of fracture healing and postoperative quality of life after rehabilitation. We believe that the described surgical method, although technically demanding, with a variable length duration of surgery and treatment of high risk elderly patients, provides stable fracture fixation with early rehabilitation to improve the quality of life.