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1Preliminary remarks

Extramedullary and intramedullary fixation devices are available for unstable type of multifragmentary pertrochanteric fractures

A multifragmentary pertrochanteric fracture without a distal extension or without another fracture distally can be treated successfully with a short IM nail. Preoperatively check the degree of the anterior bow of the femur on an x-ray of the uninjured extremity. If the tip of the nail comes to lie at the apex of the anterior bow, use a long nail or choose a plate.
We shall demonstrate now the steps for the insertion of a short proximal femoral intramedullary nail (PFNA).