Sub-trochanteric femoral fractures: challenges and solutions

Abstract

Sub-trochanteric femoral fractures represent around 10–34% of proximal femoral fragility fractures. They are notoriously difficult to treat, particularly achieving and maintaining reduction, which in turn can lead to longer operative time, more blood loss and higher rates of non-union. This review article provides an update on the potential reasons why fixation of sub-trochanteric fractures may fail, which implants are available, and what techniques can be used to try to avoid failure. Key papers from 2016 onwards were reviewed to deliver an overview of complications, implant choice, reduction techniques and consequences of open reduction.