Proximal femoral fractures are common in older adults. Zimmer natural nail (ZNN, Cephalomedulary Asia; Zimmer, Warsaw, IN, USA) known as useful in immobilizing the fractures of the proximal femoral fractures, have a critical complications like femoral head perforation and cut through in pelvic bone. We report a case that the femoral head perforation by the hip screw occured within 2 months of the operation, and 8 months after operation, the hip screw is completely separated from the metal body and cut through the pelvis.

Due to the thick cortical structure, subtrochanteric fractures of femur is often caused by high energy trauma and there are only a few report of it from low energy trauma. We have experienced a case of bilateral subtrochanteric fracture which oc-curred after a simple slip down. The fracture was healed with applying intramedullary nail. We believe the fracture may have occurred from prolonged use of steroid which was used to treat underlying rheumatoid arthritis.

The purpose of this study is to analyze the results of treatment of unstable intertrochanteric fractures with compression hip screw and wiring. Twenty one cases of intertrochanteric fractures of the 20 patients treated with compression hip screw and wiring between January 2009 and December 2013 were analyzed. Twenty cases were united and the mean union time was 17.5 weeks. The results of treatment of unstable trochanteric fractures with compression hip screw were relatively satisfactory.

The purpose of this study was to develop guidelines to improve the health of an elderly population classified into unilateral and bilateral hip fracture groups based on the mortality and risk factors affecting survival time. In the bilateral fracture group, the incidence of fracture was 3.1%, whereas mortality was 35%, average age was 83.9, and the male to female ratio was 3:17. In patients older than 75 years of age with a unilateral fracture, close ambulatory follow up is needed to avoid bilateral fracture and protect against secondary fracture within 3 years.