Abstract
Intramedullary nail fixation is the predominant mode of treating subtrochanteric femur fractures in adult patients. Owing to the various deforming forces of the proximal femur, the relatively large canal diameter, and often-present comminution, successful closed reduction and intramedullary nail fixation of subtrochanteric fractures can be technically challenging. Here we review the how and why of intraoperative techniques shown to achieve and maintain anatomic alignment and improve fraction union rates.