Subtrochanteric fractures of the femur through the track of the lower Garden screw—treatment with a Richards sliding screw

Four cases of subcapital femoral fractures, initially treated by internal fixation with Garden screws and subsequently complicated by subtrochanteric fractures through the lower screw hole, have been successfully treated by substitution of a Richards sliding screw of corresponding angle for the lower screw. All 4 subtrochanteric fractures united without implant failure. One subcapital fracture failed to unite and secondary femoral head replacement was unimpeded.