Abstract
Subtrochanteric femur fractures are significant injuries that despite surgery can lead to relatively high rates of nonunion, malunion, and subsequent poor clinical outcomes.
References
Boyd HB, Griffin LL. Classification and treatment of trochanteric fractures. Arch Surg. 1949;58(6):853–66.
Bergman GD, Winquist RA, Mayo KA, Hansen ST. Subtrochanteric fracture of the femur. Fixation using the Zickel nail. J Bone Joint Surgery Am. 1987;69(7):1032–40.
Robey LR. Intertrochanteric and subtrochanteric fractures of the femur in the Negro. J Bone Joint Surg Am. 1956;38-A(6):1301–12.
Velasco RU, Comfort TH. Analysis of treatment problems in subtrochanteric fractures of the femur. J Trauma. 1978;18(7):513–23.
Waddell JP. Subtrochanteric fractures of the femur: a review of 130 patients. J Trauma. 1979;19(8):582–92.
Goh SK, Yang KY, Koh JS, et al. Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br. 2007;89(3):349–53.
Kwek EB, Goh SK, Koh JS, Png MA, Howe TS. An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy? Injury. 2008;39(2):224–31.
Lenart BA, Neviaser AS, Lyman S, et al. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos Int. 2009;20(8):1353–62.
Grechenig W, Pichler W, Clement H, Tesch NP, Grechenig S. Anatomy of the greater femoral trochanter: clinical importance for intramedullary femoral nailing. Anatomic study of 100 cadaver specimens. Acta Orthop. 2006;77(6):899–901.
Grisell M, Moed BR, Bledsoe JG. A biomechanical comparison of trochanteric nail proximal screw configurations in a subtrochanteric fracture model. J Orthop Trauma. 2010;24(6):359–63.
Kraemer WJ, Hearn TC, Powell JN, Mahomed N. Fixation of segmental subtrochanteric fractures. A biomechanical study. Clin Orthop Relat Res. 1996;332:71–9.
Koch JC. The laws of bone architecture. Am J Anat. 1917;21:177–298.
Wiss DA, Brien WW. Subtrochanteric fractures of the femur. Results of treatment by interlocking nailing. Clin Orthop Relat Res. 1992;(283):231–6.
Starr AJ, Hay MT, Reinert CM, Borer DS, Christensen KC. Cephalomedullary nails in the treatment of high-energy proximal femur fractures in young patients: a prospective, randomized comparison of trochanteric versus piriformis fossa entry portal. J Orthop Trauma. 2006;20(4):240–6.
Brien WW, Wiss DA, Becker V, Lehman T. Subtrochanteric femur fractures: a comparison of the Zickel nail, 95 degrees blade plate, and interlocking nail. J Orthop Trauma. 1991;5(4):458–64.
Forward DP, Doro CJ, OʼToole RV, et al. A biomechanical comparison of a locking plate, a nail, and a 95° angled blade plate for fixation of subtrochanteric femoral fractures. J Orthop Trauma. 2012;26(6):334–40.
French BG, Tornetta P. Use of an interlocked cephalomedullary nail for subtrochanteric fracture stabilization. Clin Orthop Relat Res. 1998;348:95–100.
Kummer FJ, Olsson O, Pearlman CA, Ceder L, Larsson S, Koval KJ. Intramedullary versus extramedullary fixation of subtrochanteric fractures. A biomechanical study. Acta Orthop Scand. 1998;69(6):580–4.
Pugh KJ, Morgan RA, Gorczyca JT, Pienkowski D. A mechanical comparison of subtrochanteric femur fracture fixation. J Orthop Trauma. 1998;12(5):324–9.
Rydell NW. Forces acting on the femoral head-prosthesis. A study on strain gauge supplied prostheses in living persons. Acta Orthop Scand. 1966;37(Suppl 88):81–132.
Frankel VH, Burstein AH. Orthopaedic biomechanics. Philadelphia: Lea & Febiger; 1970.
Fielding JW, Cochran GV, Zickel RE. Biomechanical characteristics and surgical management of subtrochanteric fractures. Orthop Clinics N Am. 1974;5(3):629–50.
Rybicki EF, Simonen FA, Weis EB. On the mathematical analysis of stress in the human femur. J Biomech. 1972;5(2):203–15.
Froimson AI. Treatment of comminuted subtrochanteric fractures of the femur. Surg Gynecol Obstet. 1970;131(3):465–72.
Loizou CL, McNamara I, Ahmed K, Pryor GA, Parker MJ. Classification of subtrochanteric femoral fractures. Injury. 2010;41(7):739–45.
Russell T, Taylor J. Subtrochanteric fractures of the femur. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, editors. Skeletal trauma. Fractures, dislocations, ligamentous injuries. 1st ed. Philadephia: Saunders; 1992. p. 1485–524.
Muller ME, Nazarian S, Koch P. J. S. The AO classification of fractures of long bones. Berlin, Heidelberg: Springer-Verlag; 1990.
Hussmann B, Lendemans S. Pre-hospital and early in-hospital management of severe injuries: changes and trends. Injury. 2014;45(Suppl 3):S39–42.
Radvinsky DS, Yoon RS, Schmitt PJ, Prestigiacomo CJ, Swan KG, Liporace FA. Evolution and development of the advanced trauma life support (ATLS) protocol: a historical perspective. Orthopedics. 2012;35(4):305–11.
Yoon RS, Hwang JS, Beebe KS. Long-term bisphosphonate usage and subtrochanteric insufficiency fractures: a cause for concern? J Bone Joint Surg Br. 2011;93(10):1289–95.
Yoon RS, Beebe KS, Benevenia J. Prophylactic bilateral intramedullary femoral nails for bisphosphonate-associated signs of impending subtrochanteric hip fracture. Orthopedics. 2010;33(4). doi: 10.3928/01477447-20100225-21. Epub 2010 Apr 16. Epub 2010 Apr 16.
Kao CM, Huang PJ, Chen CH, Chen SJ, Cheng YM. Atypical femoral fracture after long-term alendronate treatment: report of a case evidenced with magnetic resonance imaging. Kaohsiung J Med Sci. 2012;28(10):555–8.
Bush LA, Chew FS. Subtrochanteric femoral insufficiency fracture following bisphosphonate therapy for osseous metastases. Radiol Case Rep. 2008;3(4):232.
Probst S, Rakheja R, Stern J. Atypical bisphosphonate-associated subtrochanteric and femoral shaft stress fractures: diagnostic features on bone scan. Clin Nucl Med. 2013;38(5):397–9.
Saleh A, Hegde VV, Potty AG, Schneider R, Cornell CN, Lane JM. Management strategy for symptomatic bisphosphonate-associated incomplete atypical femoral fractures. HSS J. 2012;8(2):103–10.
Banffy MB, Vrahas MS, Ready JE, Abraham JA. Nonoperative versus prophylactic treatment of bisphosphonate-associated femoral stress fractures. Clin Orthop Relat Res. 2011;469(7):2028–34.
Resch S, Thorngren KG. Preoperative traction for hip fracture: a randomized comparison between skin and skeletal traction in 78 patients. Acta Orthop Scand. 1998;69(3):277–9.
Zickel RE. Subtrochanteric femoral fractures. Orthop Clinics N Am. 1980;11(3):555–68.
Brumback RJ, Toal TR, Murphy-Zane MS, Novak VP, Belkoff SM. Immediate weight-bearing after treatment of a comminuted fracture of the femoral shaft with a statically locked intramedullary nail. J Bone Joint Surgery Am. 1999;81(11):1538–44.
Johnson KD, Tencer AF, Sherman MC. Biomechanical factors affecting fracture stability and femoral bursting in closed intramedullary nailing of femoral shaft fractures, with illustrative case presentations. J Orthop Trauma. 1987;1(1):1–11.
Wang J, Ma XL, Ma JX, et al. Biomechanical analysis of four types of internal fixation in subtrochanteric fracture models. Orthop Surg. 2014;6(2):128–36.
Ricci WM, Schwappach J, Tucker M, et al. Trochanteric versus piriformis entry portal for the treatment of femoral shaft fractures. J Orthop Trauma. 2006;20(10):663–7.
Ostrum RF, Marcantonio A, Marburger R. A critical analysis of the eccentric starting point for trochanteric intramedullary femoral nailing. J Orthop Trauma. 2005;19(10):681–6.
Ostrum RF, Levy MS. Penetration of the distal femoral anterior cortex during intramedullary nailing for subtrochanteric fractures: a report of three cases. J Orthop Trauma. 2005;19(9):656–60.
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.
Afsari A, Liporace F, Lindvall E, Infante A Jr, Sagi HC, Haidukewych GJ. Clamp-assisted reduction of high subtrochanteric fractures of the femur. J Bone Joint Surg Am. 2009;91(8):1913–8.
Beingessner DM, Scolaro JA, Orec RJ, Nork SE, Barei DP. Open reduction and intramedullary stabilisation of subtrochanteric femur fractures: a retrospective study of 56 cases. Injury. 2013;44(12):1910–5.
Hoskins W, Bingham R, Joseph S, et al. Subtrochanteric fracture: the effect of cerclage wire on fracture reduction and outcome. Injury. 2015;46(10):1992–5.
Joglekar SB, Lindvall EM, Martirosian A. Contemporary management of subtrochanteric fractures. Orthop Clinics N Am. 2015;46(1):21–35.
Riehl JT, Koval KJ, Langford JR, Munro MW, Kupiszewski SJ, Haidukewych GJ. Intramedullary nailing of subtrochanteric fractures--does malreduction matter? Bull Hosp Joint Dis. 2014;72(2):159–63.
Robinson CM, Houshian S, Khan LA. Trochanteric-entry long cephalomedullary nailing of subtrochanteric fractures caused by low-energy trauma. J Bone Joint Surg Am. 2005;87(10):2217–26.
Barquet A, Mayora G, Fregeiro J, López L, Rienzi D, Francescoli L. The treatment of subtrochanteric nonunions with the long gamma nail: twenty-six patients with a minimum 2-year follow-up. J Orthop Trauma. 2004;18(6):346–53.
Haidukewych GJ, Berry DJ. Nonunion of fractures of the subtrochanteric region of the femur. Clin Orthop Relat Res. 2004;419:185–8.
Whatley JR, Garland DE, Whitecloud T, Whickstrom J. Subtrochanteric fractures of the femur: treatment with ASIF blade plate fixation. South Med J. 1978;71(11):1372–5.
Kinast C, Bolhofner BR, Mast JW, Ganz R. Subtrochanteric fractures of the femur. Results of treatment with the 95 degrees condylar blade-plate. Clin Orthop Relat Res. 1989;(238):122–30.
Crist BD, Khalafi A, Hazelwood SJ, Lee MA. A biomechanical comparison of locked plate fixation with percutaneous insertion capability versus the angled blade plate in a subtrochanteric fracture gap model. J Orthop Trauma. 2009;23(9):622–7.
Mirbolook A, Siavashi B, Jafarinezhad AE, et al. Subtrochanteric fractures: comparison of proximal femur locking plate and intramedullary locking nail fixation outcome. Indian J Surg. 2015;77(Suppl 3):795–8.
El-Desouky II, Mohamed MM, Kandil AE. Clinical outcome of conventional versus biological fixation of subtrochanteric fractures by proximal femoral locked plate. Injury. 2016;47(6):1309–17.
Glassner PJ, Tejwani NC. Failure of proximal femoral locking compression plate: a case series. J Orthop Trauma. 2011;25(2):76–83.
Wieser K, Babst R. Fixation failure of the LCP proximal femoral plate 4.5/5.0 in patients with missing posteromedial support in unstable per-, inter-, and subtrochanteric fractures of the proximal femur. Arch Orthop Trauma Surg. 2010;130(10):1281–7.
Prasarn ML, Ahn J, Helfet DL, Lane JM, Lorich DG. Bisphosphonate-associated femur fractures have high complication rates with operative fixation. Clin Orthop Relat Res. 2012;470(8):2295–301.
Balasubramanian N, Babu G, Prakasam S. Treatment of non unions of subtrochanteric fractures using an anatomical proximal femur locked compression plate – a prospective study of 13 patients. J Orthop Case Rep. 2016;6(1):65–8.
Shroeder JE, Mosheiff R, Khoury A, Liebergall M, Weil YA. The outcome of closed, intramedullary exchange nailing with reamed insertion in the treatment of femoral shaft nonunions. J Orthop Trauma. 2009;23(9):653–7.
Isaacs JD, Shidiak L, Harris IA, Szomor ZL. Femoral insufficiency fractures associated with prolonged bisphosphonate therapy. Clin Orthop Relat Res. 2010;468(12):3384–92.
Broos PL, Reynders P, Vanderspeeten K. Mechanical complications associated with the use of the unreamed AO femoral intramedullary nail with spiral blade: first experiences with thirty-five consecutive cases. J Orthop Trauma. 1998;12(3):186–9.
Gugenheim JJ, Probe RA, Brinker MR. The effects of femoral shaft malrotation on lower extremity anatomy. J Orthop Trauma. 2004;18(10):658–64.
Giannoudis PV, Ahmad MA, Mineo GV, Tosounidis TI, Calori GM, Kanakaris NK. Subtrochanteric fracture non-unions with implant failure managed with the “Diamond” concept. Injury. 2013;44(Suppl 1):S76–81.
Qvick LM, Ritter CA, Mutty CE, Rohrbacher BJ, Buyea CM, Anders MJ. Donor site morbidity with reamer-irrigator-aspirator (RIA) use for autogenous bone graft harvesting in a single centre 204 case series. Injury. 2013;44(10):1263–9.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Koval, K.J., Rezaie, N., Yoon, R.S. (2018). Subtrochanteric Femur Fractures. In: Egol, K., Leucht, P. (eds) Proximal Femur Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-64904-7_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-64904-7_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-64902-3
Online ISBN: 978-3-319-64904-7
eBook Packages: MedicineMedicine (R0)