Fractures of the proximal part of the femur.

R. F. Kyle, M. E. Cabanela, T. A. Russell, M. F. Swiontkowski, R. A. Winquist, J. D. Zuckerman, A. H. Schmidt, K. J. Koval

Research output: Contribution to journalReview articlepeer-review

115 Scopus citations


The orthopaedic surgeon has a multitude of internal fixation devices and techniques available for use in the treatment of subtrochanteric fractures of the proximal femur. The successful use of second-generation locking nails is technically demanding. Close attention to positioning of the patient, reduction of the fracture, placement of the guide-wire, and insertion of the nail and of the proximal and distal locking screws is mandatory. The newer, high-strength hip-screws allow good fixation of a fracture that extends into the piriformis fossa. If medial comminution is present, this technique is best performed in conjunction with indirect reduction and bone-grafting. With proper technique, these devices allow the surgeon to manage predictably a complex subtrochanteric fracture that previously had to be treated with traction or extensive dissection and with (frequently inadequate) internal fixation.

Original languageEnglish (US)
Pages (from-to)227-253
Number of pages27
JournalInstructional course lectures
Issue number6
StatePublished - 1995


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