In a retrospective study of 41 subtrochanteric fractures treated with Zickel intramedullary nails (with a follow-up period of at least 1 year) there was a union rate of 100% (39/39). Union occurred between 4 and 7 months (average healing time 5.2 months). There were no implant failures. To date 4 patients have had their Zickel nails successfully removed. In 48% of the cases we had some difficulties with the stability of the fracture, and in 12% there was a need for additional cast immobilization. In 9 cases there was shortening of 1.5 to 4 cm (average shortening of 2 cm). Therefore we no longer recommend use of the Zickel nail in the treatment of acute subtrochanteric femur fractures.