Subtrochanteric femoral fractures.

Femoral fractures in the subtrochanteric and proximal shaft regions require special management because of the great stresses inflicted on the area. Stability is best achieved with intramedullary fixation when there is adequate control of both proximal and distal fragments. Intertrochanteric fractures with small subtrochanteric components can often be adequately fixed with strong nail plate or screw plate devices. When the major fracture is subtrochanteric, an intramedullary device should be used to permit stability of the bone by impaction. Experience with a special device composed of an intramedullary rod and triflanged nail indicates that this appliance performs well in the fixation of subtrochanteric fractures.