A biologic intramedullary fixation device for treating a bone fracture includes an internal tubular wall formed of a bioabsorbable synthetic material; and an outer wall coupled with and surrounding the internal tubular wall with an annular space therebetween. The outer wall is at least partially fenestrated and is formed of the bioabsorbable synthetic material. A biologically replaceable cement material is injectable into the annular space between the internal tubular wall and the outer wall.