Subtrochanteric fracture as a complication of proximal femoral pinning.

The circumstances of subtrochanteric fractures following the use of multiple pins for fixation of femoral neck fractures were reviewed in four women (age range, 67-94 years). Internal fixation by use of multiple pins in the proximal femur is a common orthopedic procedure. The pins, however, create a significant stress riser in the lateral subtrochanteric cortex. Subtrochanteric fracture has been reported after internal fixation of slipped capital femoral epiphysis with multiple conventional pins and, recently, after internal fixation of femoral neck fractures with large Garden screws.