The Consequences of Subtrochanteric Fracture with Suboptimal Surgical Fixation Leading to Multiple Surgical Revisions: A Case Report

Subtrochanteric fractures are relatively rare and challenging for orthopedic surgeons.Failing to achieve proper alignment during surgery can result in devastating sequela and necessitate more complex reoperation.We present a case of a 50-year-old man with a history of diabetes and hypertension who suffered a right subtrochanteric fracture after a motor vehicle collision.He was treated with intramedullary fixation of the femur.Upon follow-up, the fracture was complicated by nonunion due to improper alignment and fixation method at the index procedure.Two attempts at revision with nailing and plating failed.Ultimately, we treated the patient with a revision nailing and autograft of the nonunion site which led to a desirable outcome and union of the fracture.This case highlights the complex and challenging nature of subtrochanteric fractures, which can require multiple interventions, consideration of underlying medical conditions, and perseverance in treatment before achieving successful outcomes.