Head

A Subtrochanteric fracture involves the shaft of the femur directly below the lesser trochanter and may extend down the shaft of the femur.   The Subtrochanteric region is between the inferior border of the lesser trochanter and the isthmus of the femoral shaft and the inferior border of the lesser trochanter to the junction of proximal and middle one third of the femur (Dar et al., 2010).   The Subtrochanteric hip fracture is said to be one of the most complex and complicated fractures of the body (Bedi & Le, 2004).   This particular fracture is classed as a high energy trauma fracture in the young and is generally accompanied with other injuries. In the elderly it is classed as a low energy trauma and is mainly due to osteoporosis and the low bone density that complements it (Micic et al., 2010).   This fracture mostly occurs to the elderly as the cancellous bone tends to diminish with age making it extremely easy to have an injury with minimal effort.   It is said that the elderly can actually sustain the fracture before they even hit a hard surface as it may just be the twisting motion of the body that causes the fracture (Dar et al., 2010).   Treatment for this fracture is recognised as being the main challenge due to the minimal vascularity (Dar et al., 2010).  
Bone healing following an open reduction and internal fixation (ORIF) cascades a whole sequence of molecular and biological processes, that are undertaken in the bone being able to heal in a correct and positive manner (Tosounidis et al., 2009).   The bone healing process undertakes a number of steps for the regeneration of the fracture.   If one of these processes is altered in any way then the process cannot move forward and the healing of the fracture will not continue (Zimmermann et al., 2012).   The first step of bone and fracture healing is the initial formation of hematoma, and then followed by inflammation, repair and remodelling (Pape et al., 2010).   The processes of healing bone fractures in the...