Reduction techniques for difficult subtrochanteric fractures

  • Zinon T. Kokkalis
  • Andreas F. MavrogenisEmail author
  • Dimitris I. Ntourantonis
  • Vasilios G. Igoumenou
  • Thekla Antoniadou
  • Renos Karamanis
  • Panayiotis D. Megaloikonomos
  • Georgios N. Panagopoulos
  • Dimitrios Giannoulis
  • Eleftheria Souliotis
  • Theodosis Saranteas
  • Panayiotis J. Papagelopoulos
  • Elias Panagiotopoulos
Technical Note • HIP - FRACTURES


Subtrochanteric fractures can result from high-energy trauma in young patients or from a fall or minor trauma in the elderly. Intramedullary nails are currently the most commonly used implants for the stabilization of these fractures. However, the anesthetic procedure for the patients, the surgical reduction and osteosynthesis for the fractures are challenging. The anesthetic management of orthopedic trauma patients should be based upon various parameters that must be evaluated before the implementation of any anesthetic technique. Surgery- and patient-related characteristics and possible comorbidities must be considered during the pre-anesthetic evaluation. Adequate fracture reduction and proper nail entry point are critical. Understanding of the deforming forces acting on various fracture patterns and knowledge of surgical reduction techniques are essential in obtaining successful outcomes. This article discusses the intraoperative reduction techniques for subtrochanteric fractures in adults and summarizes tips and tricks that the readers may find useful and educative.


Hip fractures Subtrochanteric Reduction techniques Anesthesia 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Zinon T. Kokkalis
    • 1
  • Andreas F. Mavrogenis
    • 3
    Email author
  • Dimitris I. Ntourantonis
    • 1
  • Vasilios G. Igoumenou
    • 3
  • Thekla Antoniadou
    • 3
  • Renos Karamanis
    • 3
  • Panayiotis D. Megaloikonomos
    • 3
  • Georgios N. Panagopoulos
    • 3
  • Dimitrios Giannoulis
    • 2
  • Eleftheria Souliotis
    • 2
  • Theodosis Saranteas
    • 2
  • Panayiotis J. Papagelopoulos
    • 3
  • Elias Panagiotopoulos
    • 1
  1. 1.Department of OrthopaedicsUniversity of Patras, School of MedicineRio-PatrasGreece
  2. 2.Second Department of AnesthesiologyNational and Kapodistrian University of Athens, School of MedicineAthensGreece
  3. 3.First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of MedicineAthensGreece

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