A 53 year old construction foreman was inspecting a building when he fell 8 feet through an unmarked opening in the floor landing and directly on his right hip. He had an obvious closed fracture of his femur, which was unstable, deformed, and swollen. He was taken to a local hospital, where a radiograph of his thigh was taken that showed a comminuted fracture involving the intertrochanteric and subtrochanteric regions of the right femur (Figure 1).
The fracture was classified according to the OTA system as a 31-A2.3 (femur, proximal, pertrochanteric, multi-fragmentary, extending more than 1 cm below the lesser trochanter).