title: Subtrochanteric femur fracture treated by intramedullary fixation.
abstract: OBJECTIVE
  To discuss surgical technique, operative efficacy and clinical outcome of intramedullary fixation in the treatment of subtrochanteric femur fractures.
  
  
  METHODS
  From February 2011 to February 2013, 76 cases of subtrochanteric femur fractures were treated by intramedullary fixation in our hospital, including 53 males and 23 females, with the age range of 37 -72 years (mean 53.5 years). According to Seinsheimer classification, there were 2 cases of type I, 7 type II, 15 type III, 23 type IV and 29 type V. Firstly, all patients underwent closed reduction with the guidance of C-arm fluoroscopy in a traction table. Two cases of type I and 3 cases of type III fractures had ideal closed reduction followed by internal fixation. The others needed additional limited open reduction. Radiographic examination was used to evaluate callus formation and fracture healing in postoperative 1, 3, 6 and 12 months follow-up. Functional recovery was evaluated by Harris Hip Scoring (HHS) system.
  
  
  RESULTS
  Patients were followed up for 6-12 months. All fractures were healed except one patient with delayed union. The average bone union time was 4.5 months. According to HHS system, 65 cases were considered as excellent in functional recovery, 8 good, 2 fair and 1 poor. The proportion of the patients with excellent and good recovery was 96.05%.
  
  
  CONCLUSIONS
  Intramedullary fixation is feasible for the treatment of subtrochanteric femur fracture. The accuracy of intraoperative reduction and surgical skill are important for the clinical outcome and the patients' prognosis.
authors.affiliation: Medical College of Soochow University, Shanghai 200233, China.
authors.forename: Zu-Bin
authors.initials: ZB
authors.lastname: Zhou
authors.forename: Song
authors.initials: S
authors.lastname: Chen
authors.forename: You-Shui
authors.initials: YS
authors.lastname: Gao
authors.forename: Yu-Qiang
authors.initials: YQ
authors.lastname: Sun
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
authors.forename: Yao
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000145:classification / Q000601:surgery*; D005471:Fluoroscopy; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D016896:Treatment Outcome