pathological fractures intramedullary nail intramedullary fem nail fixation proximal femur with the intramedullary intramedullary nailing for impending or intraoperative iatrogenic fracture intraoperative iatrogenic fracture prophylactic fem im nailing periosteal stripping performed in a 27 segmental fem fractures impending fracture prophylactic intramedullary fem nail fixation periosteal stripping and prophylactic