Related Experiment Video
Updated: Jan 17, 2026
04:41
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
923
Differences Between Atypical and Typical Subtrochanteric Fractures Due to Low-Energy Trauma
Shuhei Hiyama1, Hiroo Nakajima1, Jiro Ando1
1Department of Orthopaedics, Jichi Medical University, Shimotsuke, JPN.
Cureus
|September 16, 2025
Summary
Atypical subtrochanteric fractures (ASF) in younger patients on antiresorptive therapy heal slower and have higher nonunion rates than typical subtrochanteric fractures (TSF). Current treatments may be insufficient for ASF, suggesting a need for enhanced biological approaches.
Area of Science:
- Orthopedics
- Traumatology
- Geriatric Medicine
Background:
- Low-energy subtrochanteric femur fractures are rising in aging populations.
- These fractures are classified as atypical (ASF) or typical (TSF).
- ASF are often associated with antiresorptive therapy.
Purpose of the Study:
- Compare characteristics of ASF and TSF.
- Evaluate surgical approaches for ASF vs. TSF.
- Analyze clinical outcomes, including healing and nonunion rates.
Main Methods:
- Retrospective cohort study of 49 patients with low-energy subtrochanteric femur fractures.
- Fractures classified using American Society for Bone and Mineral Research (ASBMR) criteria.
- Demographics, surgical methods, and outcomes (healing time, nonunion) were statistically compared.
Main Results:
- ASF group (23 patients) was younger and had higher antiresorptive therapy use than TSF group (26 patients).
- ASF patients received more auxiliary plating and teriparatide but showed delayed healing (9.0 vs. 5.8 months) and higher nonunion rates (39.1% vs. 0%).
- Significant differences in age, therapy use, healing time, and nonunion rates were observed (p < 0.01).
Conclusions:
- Atypical subtrochanteric fractures exhibit poorer healing outcomes than typical subtrochanteric fractures.
- Standard TSF treatment strategies may be inadequate for ASF.
- Biological augmentation, like bone grafting, should be considered for initial ASF management.
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