Treatment of Subtrochanteric Fracture

The subtrochanteric fracture of the femur is frequently difficult to immobilize because of the unusual stresses in this area. We treated 33 cases (35 fractures) of the subtrochanteric fracture from 1982 to 1987. The age range was from 2 to 93 years, with an average of 60 years. Fractures were classified as Type I (10 cases), Type II (15 cases), Type III (6 cases), or Type IV (4 cases) as defined by Ender. We reported especially the treatment by Ender's nail. Ender nailing was carried out in 17 cases. All fractures united successfully. Seven patients showed varus deformity.In young patients, open reduction and anatomic fixation of the fracture fragments might be expected to give a better anatomic and functional result than blind intramedullary nailing. But in elderly osteoporotic patients or to comminuted fractures, Ender nailing was considered to be more useful.