Subtrochanteric fracture

A subtrochanteric fracture is a break in the upper part of your thigh bone, just below the bony bumps where the powerful hip muscles attach. It's one of the toughest areas of the femur to fix surgically — the inner side of the bone is constantly squeezed while the outer side is constantly stretched, so the hardware has to handle big forces from day one. These fractures hit two very different groups of patients: younger people in high-energy events (car wrecks, falls from height) and older patients on long-term bisphosphonate medications (the bone-density drugs like alendronate / Fosamax), where the bone can crack from a low-energy fall or even spontaneously — what we call an atypical femur fracture.

Upper thigh pain, inability to put any weight on the leg, and thigh swelling — sometimes a visible deformity. We get X-rays of the pelvis and the entire length of the thigh bone. A CT scan adds detail when the bone is shattered into many pieces. For patients on bisphosphonates, we also X-ray the opposite thigh — atypical fractures often start as a stress reaction on the other side that's quietly building toward the same break.

Nearly all subtrochanteric fractures get surgery. The repair uses a long metal nail driven down the inside of the thigh bone (a cephalomedullary nail) or a heavy plate-and-screw construct on the outside — whichever gives the most stable fix for that specific fracture pattern. The goal is stable enough hardware to let you start moving and bearing weight as quickly as possible.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Hip (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language