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This is an archived page which is no longer updated.
Please visit the main page to look for a current version |
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Subtrochanteric Femur Fracture
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Low subtrochanteric fracture
- Below lesser trochanter with piriformis fossa intact
- Treatment = standard locked IM nail
- Proximal fragment is typically externally rotated and flexed due to the pull of the iliopsoas (Iliacus/ Psoas) and abducted by the short abductors inserting into the greater trochanter.
- Distal fragment is displaced medially by the adductor magnus.
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High subtrochanteric fracture
- Fractures with extention above the lesser trochanter
- Treatment = locked cephalomedullary nail.
- Beware of varus malreduction. The primary reason for this is failing to counteract the muscle forces acting on the proximal fragment combined with the adducted position of the distal femur during portal creation.
- Ensure anatomic reduction before guide wire and nail insertion. A clamp placed on the proximal fragment can be used to control proximal fragment movement and prevent eccentric reaming. In addition, excessive adduction of the distal fragment during reaming and nail placement should be avoided. (French BG, Tornetta P III: Clin Orthop 1998;348:95-100).
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| Femoral Nails
Biomet Peritroch
Biomet Uniflex
Biomet Vector
Stryker Gamma Nail
Stryker T2 Nail
Synthes Prox Femur
Synthes Fem Shaft
Zimmer ITST
Zimmer MD/N
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