Experience With Treatment of Subtrochanteric Fracture

Subtrochanteric fractures of the femur are sometimes difficult to immobilize because of the extraordinary stress on this area. Between 1986 and 1991, we experienced 58 fractures in 57 patients ranging from 17 to 94 years of age (mean; 58.1 years). The fractures were classified according to Seinsheiner as Type II A in 3 fractures and Type II B, Type II C, Type III A, Type III B, Type IV and Type V in 13 fractures, 11 fractures, 14 fractures, 2 fractures, 6 fractures and 9 fractures, respectively. All cases were treated by osteosynthesis, Ender nailing being carried out for 39 fractures (67%), and all fractures except one united successfully. Fractures in young patients with open reduction and anatomical fixation of the fragments obtained a good anatomical and functional result rather than blind intramedullary naling, while Ender nailing was considered to be more favorable in elderly patients and for comminuted fractures.