BACKGROUND: Surgical treatment of comminuted subtrochanteric fractures may be associated with high incidences of non-union and implant failure. Biological fixation may solve this problem by encouraging rapid callus formation METHODS: In all, 4 patients with comminuted subtrochanteric femur fractures underwent indirect reduction and biological internal fixation. The mean age of the group was 38 (21-55) years. RESULTS: Patients were followed up for a mean of 24 (12-48) months. Union was achieved within14 to 16 weeks, with no cases of delayed union or non-union. According to the Traumatic Hip Rating Scale, functional results were excellent in 1 and good in 3 cases. CONCLUSIONS: Indirect reduction and biological internal fixation yield acceptable results in comminuted fractures.