Introduction:

Most cases of subtrochanteric femur fractures in young individuals result from high-energy trauma like traffic accidents or falls. These cases often present with complex, commiunted fractures requiring open reduction and wiring.

Study details:

We reviewed 10 cases (9 male, 1 female, mean age 36±7.8 years) of subtrochanteric femur fractures treated at our trauma center over ten years.

Results:

The predominant injury mechanisms were falls from height (5 cases) and traffic accidents (4 cases). Fracture patterns included Seinsheimer Type III and IV (2 cases each), with significant comminution. Pelvic fractures were the most common complication, occurring in six cases, followed by chest trauma in four cases and maxillomandibular fractures in three cases. Six patients had an ISS score exceeding 16. All patients underwent long nail fixation, with six cases requiring open reduction. Additional fixation methods included wiring in five cases and augment plating in one case. All patients with follow-up achieved complete bone union without requiring reoperation.

Discussion:

Among the subtrochanteric femur fracture cases taken to our trauma center, all 5 cases resulting from falls were associated with pelvic trauma. In cases with pelvic fractures, it is necessary to first stabilize the pelvis with external fixation or screw fixation during initial treatment, and then proceed with early internal fixation of the subtrochanteric femur fracture. Many of these cases involve comminuted subtrochanteric fractures, generally requiring open reduction. In our study, all 5 cases of falls from heights underwent open reduction with additional wiring or augment plating. As a result, most cases achieved bone union without issues, suggesting that for subtrochanteric femur fractures caused by falls from heights, achieving secure reduction through open reduction and strong fixation with additional wiring is crucial.

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