Subtrochanteric

Clinical features

• Hip pain with swelling

• Shortened and externally rotated leg

• Significant ecchymosis

Diagnostics [12]

• X-ray : fracture between the lesser trochanter up to 5cm below that (distally)

• MRI if a pathological fracture is suspected

Treatment

• Consider conservative approach (e.g., traction) in surgically unstable patients

• Surgery is indicated in displaced/nondisplaced fractures in adults, especially if associated with multiple trauma, an open fracture, or pathological fractures

  • Long intramedullary nail with a lag screw

  • Locking plate may be considered for complicated fractures (e.g., pre-existing femoral deformity, associated femoral neck fracture)