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Upper Thigh Fractures (Subtrochanteric Fractures)

Subtrochanteric fractures are breaks in the upper thigh bone (femur) just below the hip joint - most occur in elderly people with osteoporosis from low-energy falls or in younger people from high-energy trauma (car accidents, falls from height), typically requiring surgery with a metal rod and screws (intramedullary nail) inserted down the center of the thigh bone to stabilize the fracture - recovery takes 3-6 months with gradual weight-bearing progression, though some patients develop healing complications (non-union) requiring further surgery, particularly those taking long-term bisphosphonate medications who develop atypical fractures with unique fracture patterns

📅Last reviewed: January 2025đŸĨBones & Joints

📖What is Upper Thigh Fractures (Subtrochanteric Fractures)?

Subtrochanteric fractures are breaks in the upper thigh bone (femur) just below the hip joint - most occur in elderly people with osteoporosis from low-energy falls or in younger people from high-energy trauma (car accidents, falls from height), typically requiring surgery with a metal rod and screws (intramedullary nail) inserted down the center of the thigh bone to stabilize the fracture - recovery takes 3-6 months with gradual weight-bearing progression, though some patients develop healing complications (non-union) requiring further surgery, particularly those taking long-term bisphosphonate medications who develop atypical fractures with unique fracture patterns

đŸ”ŦWhat Causes It?

  • Low-energy fall in elderly with osteoporosis (most common cause in patients over 65)
  • High-energy trauma in younger patients (car accident, motorcycle crash, fall from height)
  • Long-term bisphosphonate use (osteoporosis medication) causing atypical fractures
  • Pathological fracture through bone weakened by cancer metastases or other bone disease

âš ī¸Risk Factors

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You may be at higher risk if:

  • Osteoporosis (weak, brittle bones - most common risk factor in elderly)
  • Long-term bisphosphonate use (5+ years of Fosamax, Actonel, other osteoporosis drugs)
  • Advanced age (risk increases significantly after 65)
  • Previous hip or femur fracture
  • Female gender (higher osteoporosis rates)
  • Vitamin D deficiency
  • Cancer with bone metastases

đŸ›Ąī¸Prevention

  • ✓Osteoporosis screening and treatment (bone density scans after 65 for women, 70 for men)
  • ✓Fall prevention strategies (home safety assessment, vision checks, medication review)
  • ✓Regular weight-bearing exercise and strength training
  • ✓Adequate calcium (1200mg daily) and vitamin D (800-1000 IU daily) intake
  • ✓If on bisphosphonates 5+ years: discuss drug holiday with doctor to reduce atypical fracture risk
  • ✓Stop smoking (impairs bone healing and increases fracture risk)