Objective: To evaluate the clinical and radiographic outcomes of unstable proximal femoral fractures treated by minimal invasive technigues.

Method: In a retrospective study, between 1991–2003, 93 patients with closed pertrochanteric femoral fractures were treated with gamma-nail.This intramedullary device was used only for unstable intra and subtrochanteric( A3 and A,B respectively, according A.O. clasiffication) fractures and only in cases which adeguate closed reduction was attainable. There were 32 men and 61women with an average of 76 years( range 50 to 95 years). Immediate weight bearing was permitted in 75 patients. Sixty eight patients were available for clinical and radiographic assesment (at least 1 year F.U.).

Results: At 6 months 92% of the fractures were healed. Complications included intraoperative was: 1 diaphyseal fracture required cerclage wiring ,and postoperative were:2 diaphysial fractures at the distal end of nail, 1migration of the lag screw within the femoral head,2 perforations of lag screw towards cranial,1 infection and 2 nonunions reguired T.H.R. Two patients complained of thigh pain.

Conclusions: Gamma nail is a good minimal invasive implant of unstable proximal femoral fractures, if closed reduction is feasible. Permitts early immobilization and weight bearing even and in elderly patients.