Management of subtrochanteric fractures by nail osteosynthesis: a review of tips and tricks.

Introduction: Subtrochanteric fractures of femur remain most challenging injuries faced by orthopaedic surgeons. The implant choice shifted from extra medullary to intramedullary nails over the last two decades. Effort to achieve anatomical reduction before nail insertion for better outcomes has been emphasized well in literature. We reviewed various surgical techniques for reduction of fracture in more biological way that can be used to overcome the deforming forces of the muscles acting on fracture fragments.

Conclusion: Regardless of the closed vs open reduction for subtrochanteric fracture fixation, the key point to reduce the risk of complications is quality of reduction of fracture. This article highlights specific strategies to achieve reliable, efficient and desired outcomes when using intramedullary nails for subtrochanteric fractures.