How is a subtrochanteric fracture treated?

Surgery is usually the main treatment for subtrochanteric fractures. Surgical options include external fixation, intramedullary fixation or by using plates and screws. External fixation is a temporary fixation and used for severe open fractures.

What is a subtrochanteric femur fracture?

Subtrochanteric (ST) femur fractures are defined as fractures of the proximal femur that occur within 5 cm of the lesser trochanter. 1. Overall, the incidence of these fractures has been estimated to be approximately 15–20 per 100,000 individuals.

How can subtrochanteric fracture be reduced?

Although several methods of treatment options have been reported in the recent literature, our preference is to use reamed, antegrade intramedullary nailing (IMN). Arguably the standard of care in treating subtrochanteric femur fractures, IMN can lead to reliable reproducible results.

How long does intertrochanteric fracture surgery take?

The surgeon makes a small incision (cut) on the side of your thigh. Special screws or nails are placed to hold the bones in their correct position. This surgery takes 2 to 4 hours.

What is comminuted fracture?

A comminuted (kah-muh-NOOT-ed) fracture is a type of broken bone. The bone is broken into more than two pieces.

Where is a subtrochanteric fracture located?

Subtrochanteric fractures are located between the lesser trochanter and the femoral isthmus that is, in the proximal part of the femoral shaft. They are less common than femoral neck and intertrochanteric fractures, accounting for approximately 5% to 15 % of hip fractures.

How is a broken femur treated?

Currently, the method most surgeons use for treating femoral shaft fractures is intramedullary nailing. During this procedure, a specially designed metal rod is inserted into the canal of the femur. The rod passes across the fracture to keep it in position.

What is Subtrochanteric extension?

The subtrochanteric region is defined as within 5 centimeters distal to the lesser trochanter. Subtrochanteric fractures often are associated with intertrochanteric fractures. The strong gluteal and thigh muscles create a classic deformity. The proximal fragment is held in abduction, flexion, and external rotation.

How can I reduce my femur?

Open reduction and internal fixation (ORIF) is surgery used to stabilize and heal a broken bone. You might need this procedure to treat your broken thighbone (femur). The femur is the large bone in the upper part of your leg. Different kinds of trauma can damage this bone, causing it to fracture into 2 or more pieces.

Where is the subtrochanteric region?

The subtrochanteric region is defined as within 5 centimeters distal to the lesser trochanter. Subtrochanteric fractures often are associated with intertrochanteric fractures. The strong gluteal and thigh muscles create a classic deformity.

How long does it take to walk after femur fracture surgery?

Full recovery from a femur fracture can take anywhere from 12 weeks to 12 months. But you are not alone. Most people experiencing a femur fracture can begin walking with the help of a physical therapist in the first day or two after injury and/or surgery.

How are subtrochanteric femur fractures treated in orthopaedics?

Care must be taken to avoid varus during placement of the device. Comminuted subtrochanteric fractures may be treated with a long intramedullary device or a fixed angled plate. Sliding hip screws should generally be avoided as they have higher failure rates.

Can a greater trochanteric fracture be treated non-operatively?

Typically, isolated greater trochanteric fractures can be treated non-operatively. However fractures occurring between the greater and lesser trochanters, called Intertrochanteric Fractures do require surgery, as do fractures occurring below the trochanters known as Subtrochanteric Fractures.

Which is the best treatment for a femur fracture?

Successful treatment methods require neutralization of these forces while maintaining the blood supply to enhance healing. Intramedullary nailing of the proximal femur has become the standard method of treatment for most subtrochanteric femur fractures. Contemporary femoral nails are categorized by their screw orientation and nail design.

What kind of nail to use on Subtrochanteric fractures?

Essentially all subtrochanteric fractures below the level of the lesser trochanter can be nailed with a centromedullary locking nail. For fractures with extension above the lesser trochanter (Russell-Taylor type 2), a fixed-angle device such as a blade-plate or DCS can be used, but these seem to provide less predictable results.