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Definition and Mechanism
- Subtrochanteric fractures occur within 5 cm of the lesser trochanter in the proximal femur.
- They can result from low-energy trauma in elderly or high-energy events in younger patients.
Subtrochanteric Fracture Biomechanics
- Proximal fragment tends to abduct, flex, and externally rotate due to muscle forces.
- Weight-bearing causes compressive forces medially and tensile forces laterally on the femur.
Classification Systems Explained
- Three classification systems guide subtrochanteric fracture management: Russell-Taylor, AOOTA, and ASBMR atypical fracture criteria.
- Atypical fractures show lateral cortical thickening, minimal trauma, and transverse patterns without comminution.