title: Open reduction and intramedullary stabilisation of subtrochanteric femur fractures: A retrospective study of 56 cases.
abstract: Subtrochanteric femur fractures commonly present with predictable displacement because of the deforming muscle forces acting upon the proximal femur. For this reason, successful closed reduction and femoral nailing can be a technically demanding procedure. Open reduction prior to nail placement has been advocated to improve and maintain anatomic fracture alignment. The purpose of this study was to evaluate the results of patients with closed subtrochanteric femur fractures treated with open reduction and a reamed antegrade statically locked intramedullary nail. An initial query of our database identified 154 patients who had sustained a subtrochanteric femur fracture over the defined study period. Ninety-six patients had adequate radiographic and clinical follow-up. Fifty-six (58%) patients were treated with open reduction and nail placement. There were no wound complications or infections and all patients went on to successful osseous union. There was no loss of reduction and a final coronal and sagittal plane deformity of <5 degrees in 55 of 56 (98%) patients. Open reduction of closed subtrochanteric femur fractures followed by intramedullary nailing leads to high union rates with rare complications.
authors.affiliation: University of Washington, Department of Orthopaedics and Sports Medicine - Harborview Medical Center, 325 9th Avenue, Box 359798, Seattle, WA 98104, United States. Electronic address: daphneb@uw.edu.
authors.forename: Daphne M
authors.initials: DM
authors.lastname: Beingessner
authors.forename: John A
authors.initials: JA
authors.lastname: Scolaro
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Orec
authors.forename: Sean E
authors.initials: SE
authors.lastname: Nork
authors.forename: David P
authors.initials: DP
authors.lastname: Barei
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing
keywords: Femur; Intramedullary nail; Open reduction; Subtrochanteric