[13,5,9] A laboratory study (Mahomed et al, 1994) comparing a locked Gamma nail to a standard sliding hip screw for the fixation of stable and unstable
subtrochanteric fractures showed that the intramedullary nail was more rigid and permitted less fracture displacement and concluded that intramedullary fixation was superior to extramedullary fixation.
[5] Proximal third femur includes head, neck, intertrochanteric region (between greater and lesser trochanter) and
subtrochanteric region (below lesser trochanter for about 5 cm).
Other treatment options are closed reduction, open reduction, heavy traction and abduction,
subtrochanteric osteotomy, Girdlestone arthroplasty, arthrodesis, endoprosthetic replacement and total hip replacement.3
Oh, "A computed tomography-based analysis of proximal femoral geometry for lateral impingement with two types of proximal femoral nail anterotation in
subtrochanteric fractures," Injury, vol.
The investigators identified the 1,234 cases of femoral
subtrochanteric and shaft fractures among older women that resulted from falls.
Another manufacturer-sponsored study showed that
subtrochanteric femur fractures have occurred in people who have not used bisphosphonates (Osteoporos.
(2) In 2007, Goh and colleagues reported 13
subtrochanteric fractures, nine of which occurred in patients treated with alendronate.
Of this cohort, 167 (40.9%) sustained femoral neck fractures (31-B), 214 (52.5%) intertrochanteric fractures (31-A), and 27 (6.6%)
subtrochanteric fractures (32-A(1-3).1, 32-B(1-3).1, 32-C(1-3).1).
Femoral length was reconstructed using
subtrochanteric transverse diameter, vertical and transverse head diameter in a study by Jubilant [15] et al.
(22) The most common side effects include gastrointestinal disturbance, acute phase response, renal impairment, hypocalcemia, atrial fibrillation, osteonecrosis of the jaw (ONJ), and atypical
subtrochanteric femoral fractures (AFF).
Fractures of this nature commonly occur in the femoral shaft or
subtrochanteric region but rarely occur in the upper extremities [2].