Reduction and fixation of subtrochanteric femoral fractures using the ASIF 95?? blade plate

The difficulty in treating subtrochanteric fractures is evidenced by the many modalities and techniques currently described in the orthopaedic literature. Rotational problems, shortening, implant failure, and high rates of delayed union or nonunion have been reported with the majority of the implants available today. We recommend a technique that uses indirect fracture reduction to achieve optimum axial alignment and length without aiming to achieve an anatomic reduction. Fixation is accomplished with the Association for the Study of Internal Fixation (ASIF) 95° (condylar) blade plate. Medial bone grafting is not performed, and strict attention is paid toward avoiding unnecessary soft-tissue stripping or bone devascularization. An axial load is applied to the fracture by tensioning of the plate intraoperatively. The use of this technique results in an excellent rate of union, good control of rotation and length, and minimal complications.