Operative treatment of subtrochanteric femur fractures is demanding. T
he implants available follow different biomechanical and surgical prin
ciples. Extramedullary implants like the condylar blade plate and the
dynamic condylar screw require subtle surgical and indirect reduction
techniques. Intramedullary implants like intramedullary hip screws and
interlocking nails are biomechanically advantageous. In contrast to t
he extramedullary implants these fixations can stand postoperative wei
ght-bearing. The different operative techniques for the fixation of su
btrochanteric fractures are presented and evaluated. Current trends in
treatment rationales are outlined.