الفهرس 
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Abstract
Primary osteoporosis is a skeletal disease characterised by low bone mass and micro architectural deterioration, with a resulting increase in bone fragility and hence susceptibility to fracture. It can be postmenopausal type I: or senile osteoporosis type II.
The most important diagnostic tool is the DXA scan as WHO efinition for osteoporosis is based on bone mineral density but the plain diology still of important value in diagnosing osteoporotic fractures.
The major technical problem facing the surgeon is the difficulty for btaining secure fixation of an implant to osteoporotic bone leading to ilure of fixation. This failure results from bone failure rather than implant eakage so it is preferred to perform a relative stable fixation rather than an solute stable one.
The basic principles of internal fixation in osteoporotic bone are: paction, wide buttress, long splintage and bone augmentation, in addition preserving biology of bone.
The correct balance between mechanical stability and preservation of rre perfusion is the key issue to obtain a successful osteosynthesis.