Subtrochanteric Fractures of the Femur
The subtrochanteric segment of the femur extends from the lesser trochanter to the junction of the proximal and middle thirds of the diaphysis. This segment of the femur is subjected not only to axial loads of weight bearing, but also to tremendous bending forces because of the eccentric load appli-cation to the femoral head (Fig. 12.1). Recent strain-gauge studies in vivo (Schatzker et al. 1980) have confirmed Pauwel’s and the AO/ASIF contention that the bending forces cause the medial cortex to be loaded in compression and the lateral in tension. Furthermore, they have shown that the compressive stresses in the medial cortex are signif-icantly higher than tensile stresses in the lateral cortex.
KeywordsFatigue Adduct Posite Dition Crest
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- Cochran GVB, Zickel RE, Fielding JW (1980) Stress analysis of subtrochanteric fractures: effect of muscle forces and internal fixation devices. In: Uhthoff HK (ed) Current concepts of internal fixation of fractures. Springer, Berlin Heidelberg New YorkGoogle Scholar
- Kempf I, Grosse A, Beck G (1985) Closed locked intramedullary nailing. J Bone Joint Surg 67A: 709–720Google Scholar
- Küntscher G (1967) Practice of intramedullary nailing. Thomas, Springfield, p 178Google Scholar
- Pankovich AM, Tarabishy IE (1980) Ender nailing of intertrochanteric and subtrochanteric fractures. J Bone Joint Surg 62A: 635–645Google Scholar
- Schatzker J, Manley PA, Sumner-Smith G (1980) In vivo strain-gauge study of bone response to loading with and without internal fixation of fractures. Springer, Berlin Heidelberg New York, pp 306–314Google Scholar
- Zickel RE (1976) An intramedullary fixation device for the proximal part of the femur. J Bone Joint Surg 58 A: 866–872Google Scholar