Skip to main content
SpringerLink
Log in

Subtrochanteric Femoral Fractures

  • Chapter
  • First Online:
Fracture Reduction and Fixation Techniques

  • 1338 Accesses

Abstract

Subtrochanteric fractures of the femur occur in an area with high mechanical stresses both axial and torsional. Consequently, optimum reduction and fixation are essential to avoid complications of implant failure and nonunion. Closed reduction can be difficult due to the effect of pulling forces from different muscle groups. Intramedullary devices remain the standard of care of stabilization of these fractures. In the herein chapter, the management of these fractures is discussed in relation to their fixation and reduction techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Simmermacher RK, Bosch AM, Van der Werken C. The AO/ASIF-proximal femoral nail (PFN): a new device for the treatment of unstable proximal femoral fractures. Injury. 1999;30(5):327–32.

    Article  CAS  Google Scholar 

  2. Bellabarba C, Herscovici D, Ricci WM. Percutaneous treatment of peritrochanteric fractures using the gamma nail. 2000. J Orthop Trauma. 2003;17(8 Suppl):S38–50.

    Article  Google Scholar 

  3. Utrilla AL, Reig JS, Muñoz FM, Tufanisco CB. Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma. 2005;19(4):229–33.

    Article  Google Scholar 

  4. Saudan M, Lübbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P. Peritrochanteric fractures: is there an advantage to an intramedullary nail? A randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma. 2002;16(6):386–93.

    Article  Google Scholar 

  5. Curtis MJ, Jinnah RH, Wilson V, Cunningham BW. Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation. Injury. 1994;25(2):99–104.

    Article  CAS  Google Scholar 

  6. Schipper IB, Marti RK, van der Werken C. Unstable trochanteric femoral fractures: extramedullary or intramedullary fixation. Review of literature. Injury. 2004;35(2):142–51.

    Article  CAS  Google Scholar 

  7. Pape H-C, Tarkin IS. Intraoperative reduction techniques for difficult femoral fractures. J Orthop Trauma. 2009;23(5):S6–S11. https://doi.org/10.1097/BOT.0b013e31819f2754.

    Article  PubMed  Google Scholar 

  8. Hoffmann R, Haas N. Femur: proximal. In: AO Publishing, editor. AO principles of fracture management. New York: Thieme Stuttgart; 2009. p. 441–55. https://doi.org/10.1308/003588409X432419f.

    Chapter  Google Scholar 

  9. Haidukewych GJ. Intertrochanteric fractures: ten tips to improve results. J Bone Joint Surg Am. 2009;91(3):712–9.

    PubMed  Google Scholar 

  10. Schatzker J. Subtrochanteric fractures of the femur. In: Schroder G, editor. The rationale of operative fracture care. 3rd ed. Berlin: Springer; 2005. p. 367–85. https://doi.org/10.1007/3-540-27708-0.

    Chapter  Google Scholar 

  11. Lundy DW. Subtrochanteric femoral fractures. J Am Acad Orthop Surg. 2007;15(11):663–71.

    Article  Google Scholar 

  12. Tomás J, Teixidor J, Batalla L, Pacha D, Cortina J. Subtrochanteric fractures: treatment with cerclage wire and long intramedullary nail. J Orthop Trauma. 2012;27(7):119–29. https://doi.org/10.1097/BOT.0b013e31826fc03f.

    Article  Google Scholar 

  13. Russel TA. Subtrochanteric femur fractures: reconstruction nailing. In: Hurley R, LePlante M, editors. Master techniques in orthopaedic surgery: fractures. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006. p. 291–322.

    Google Scholar 

  14. Winquist R. Locked femoral nailing. J Am Acad Orthop Surg. 1993;1(2):95–105.

    Article  CAS  Google Scholar 

  15. Farrar MJ, Binns MS. Percutaneous reduction for closed nailing of femoral shaft fractures. J R Coll Surg Edinb. 1996;41(4):267–8.

    CAS  PubMed  Google Scholar 

  16. Georgiadis GM, Burgar AM. Percutaneous skeletal joysticks for closed reduction of femoral shaft fractures during intramedullary nailing. J Orthop Trauma. 2001;15(8):570–1.

    Article  CAS  Google Scholar 

  17. Yoon RS, Donegan DJ, Liporace FA. Reducing subtrochanteric femur fractures: tips and tricks, do’s and don’ts. J Orthop Trauma. 2015;29(Suppl 4):S28–33.

    Article  Google Scholar 

  18. Moeller TB, Reif E. Lower extremity. In: Verlagsgruppe, editor. Pocket atlas of sectional anatomy: computed tomography and magnetic resonance imaging. 3rd ed. New York: Thieme Stuttgart; 2007. p. 116–40.

    Google Scholar 

  19. Afsari A, Liporace F, Lindvall E, Infante A, Sagi HC, Haidukewych GJ. Clamp-assisted reduction of high subtrochanteric fractures of the femur: surgical technique. J Bone Joint Surg Am. 2010;92(Suppl 1):217–25. https://doi.org/10.2106/JBJS.J.00158.

    Article  PubMed  Google Scholar 

  20. Schipper IB, Steyerberg EW, Castelein RM, et al. Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br. 2004;86:86–94.

    Article  CAS  Google Scholar 

Download references

Conflict of Interest

The authors declare no conflict of interest in relation to the content of this chapter.

Author information

Authors and Affiliations

  1. Academic Department of Orthopaedic Surgery, Department of Orthopaedics, University Hospital of Patras, School of Medicine, University of Patras, Rio-Patras, Greece

    Dimitris I. Ntourantonis, Zinon T. Kokkalis & Elias Panagiotopoulos

Authors
  1. Dimitris I. Ntourantonis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zinon T. Kokkalis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elias Panagiotopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, West Yorkshire, UK

    Peter V. Giannoudis

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ntourantonis, D.I., Kokkalis, Z.T., Panagiotopoulos, E. (2020). Subtrochanteric Femoral Fractures. In: Giannoudis, P. (eds) Fracture Reduction and Fixation Techniques. Springer, Cham. https://doi.org/10.1007/978-3-030-24608-2_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24608-2_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24607-5

  • Online ISBN: 978-3-030-24608-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation