Management of Subtrochanteric Proximal Femur Fractures: A Review of Recent Literature

Abstract

Subtrochanteric femur fractures are an uncommon injury in orthopedics, but when they are encountered they may present difficulties in management. The purpose of this paper is to examine the recent literature on the epidemiology, classification, initial evaluation, and definitely treatment for these injuries. These will assist the physician to determine the optimal treatment strategy and avoid potential surgical complication.

Does using different entrance points for intramedullary nails affect clinical outcomes for femoral shaft fractures? A retrospective clinical comparative study

“…A review of the current literature reveals that a meticulous assessment of supra-isthmal fractures must be carried out before deciding on a surgical entrance point, but supports the use of either entrance after meticulous assessment of the fracture [ 15 ]. Indeed, there is no “right” or “wrong” entry portal when contemplating nailing supra-isthmal femoral fractures.…”

Combined injury of femoral artery and femoral nerve after blunt trauma to the proximal femur: A case report

“…Usually, the proximal fragment abducts, externally rotates, and goes into flexion due to the pulling forces of the surrounding muscles (including the gluteus medius, gluteus minimus, short external rotators, and iliopsoas) [ 11 ]. Normally, the distal fragment also adducts due to the pulling forces of the gracilis and adductor muscles [ 11 ]. In our case, the atypical direction of displacement could be the cause of external iliac artery injury (along with the femoral artery and nerve).…”

Subtrochanteric femur fractures: management and outcomes

“…It is, also, based on the concept of relative biologic fixation because it preserves vascularization at the fracture site, particularly the periosteal blood supply, and it promotes secondary bone healing by providing relative stability 12 . It can decrease fixation failure, operative time and hospital length of stay compared to extramedullary devices 13 .…”