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Data documented and analysed included patient demographics, fracture characteristics, patient comorbidities, time to fracture union and development of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 512 patients met the inclusion criteria (523 fractures). Open reduction was performed in 48% (247) of the fractures. Following matching and regression analysis, we identified diaphyseal extension of the fracture to be associated with an open reduction (OR: 2.30; 95% CI 1.45\u20133.65;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Open reduction was also associated with an increased risk of superficial infection (OR: 7.88; 95% CI 1.63\u201338.16;<jats:italic>p<\/jats:italic>\u2009=\u20090.010), transfusion within 48\u00a0h following surgery (OR: 2.44; 95% CI 1.96\u20134.87;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a prolonged surgical time (OR: 3.09; 95% CI 1.96\u20134.87;<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The risk of non-union, deep infection and overall mortality was not increased with open reduction. The use of cerclage wires [50 out of 201 fractures (24.9%) treated with an open reduction] to achieve anatomical reduction as compared to open reduction alone significantly reduced the risk of non-union (OR: 0.20; 95% CI 0.06\u20130.74;<jats:italic>p<\/jats:italic>\u2009=\u20090.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Open reduction of subtrochanteric fractures is not associated with an increased risk of deep infection and non-union, even though it is associated with an increased risk of superficial infection, prolonged surgical time and transfusion. The use of cerclage wire is associated with reduced risk of non-union with little evidence of an increase in complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00068-021-01834-6","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T12:02:43Z","timestamp":1637928163000},"page":"1759-1768","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Management of subtrochanteric femur fractures: is open reduction associated with poor outcomes?"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-1432","authenticated-orcid":false,"given":"Michalis","family":"Panteli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Shen Hwa","family":"Vun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Michael","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony John","family":"Howard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ippokratis","family":"Pountos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Vasilios","family":"Giannoudis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"1834_CR1","first-page":"231","volume":"1992","author":"DA Wiss","year":"1992","unstructured":"Wiss DA, Brien WW. 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