title: Treatment of subtrochanteric femoral fracture with long proximal femoral nail antirotation.
abstract: OBJECTIVE
  Subtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation (PFNA-long).
  
  
  METHODS
  Between October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumferential wiring in 4 cases.
  
  
  RESULTS
  The average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed.
  
  
  CONCLUSIONS
  PFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.
authors.affiliation: Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Wen-yue
authors.initials: WY
authors.lastname: Wang
authors.forename: Tian-fu
authors.initials: TF
authors.lastname: Yang
authors.forename: Yue
authors.initials: Y
authors.lastname: Fang
authors.forename: Ming-ming
authors.initials: MM
authors.lastname: Lei
authors.forename: Guang-lin
authors.initials: GL
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies