Open Subtrochanteric Femur Fracture
PART II:
I performed an external fixation and irrigation and debridement of the fracture. Then I elected to place antibiotic beads in the wound bed while giving the soft tissue in the wound bed time to settle down.
![subtroch21](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch21-300x199.jpg)
![subtroch05](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch05-247x300.jpg)
![subtroch06](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch06-213x300.jpg)
![subtroch02](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch02-300x199.jpg)
![subtroch18](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch18-300x199.jpg)
![subtroch19](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch19-300x199.jpg)
Unfortunately, I’m not thrilled about my currently available options for continued treatment:
1. Repeat irrigation and debridement in 48 hours and treat definitively for multiplanar external fixation
2. Use second generation T2 standard intramedullary nailing
3. Employ a first generation 90 degree dynamic condylar screw (DCS) plate
4. Utilize a latest generation distal locking condylar combination plate
The following fluoro-shots are with implants superimposed over the proximal thigh.
![subtroch23](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch231-195x300.jpg)
![subtroch09](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch09-300x214.jpg)
![subtroch10](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch10-300x214.jpg)
![subtroch11](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch11-300x214.jpg)
![subtroch12](http://www.Disaster-RX.com/wp-content/uploads/2011/09/subtroch12-300x214.jpg)
What is your advice on definitive management?
What would be your prognosis for Kamal’s long-term outcome?