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A residual fracture gap after intramedullary nailing is a known risk factor for delayed union and non-union. This study aimed to report the outcomes of a forward-striking technique to reduce fracture gaps during long cephalomedullary nailing in subtrochanteric femoral fractures (SFFs).A retrospective cohort study was conducted on patients with SFFs treated in a single institution between February 2013 and October 2018. A total of 58 patients treated via long cephalomedullary nailing with a forward-striking technique were included. The width of the fracture gap, location of the cephalic screw, tip-apex distance (TAD), and time to bone union were evaluated using intraoperative and postoperative radiographs. Complication rates, including fixation failure, non-union, implant breakage, and infection, were assessed. The mean follow-up duration was 4 (range, 2‒8) years.Of the 58 patients (mean age, 67.9 years), 38 (65.5%) were female. Thirty-two cases (55.2%) were classified as atypical femoral fractures. The mean fracture gap reduced from 5.1 mm to 1.6 mm by forward striking (P0.001). The reduced fracture gap was significantly greater in atypical SFFs (mean, 4.9 mm vs. 1.7 mm; P0.001). The lag screw was located in the center-center or center-inferior zones of the femoral head in 54 patients (93.1%). The mean TAD was 14.2 mm and was under 25 mm in 55 patients (94.8%). Bone union was achieved in all cases without reoperation at a mean of 5.4 months. One incident of lag screw breakage was noted at 5 months, but bone union was achieved at 7 months.The forward-striking technique with a long cephalomedullary nail demonstrated a 100% bone union rate in a consecutive series of 58 SFFs. This technique is effective in reducing the fracture gap as well as placing the cephalic screw into the optimal position. The forward-striking technique was particularly effective in reducing atypical SFFs with a transverse or short oblique configuration.

Advanced RF packages are demonstrate with active (low-noise amplifier, RF switch) and passive integration in ultra-thin 3D glass packages with miniaturization and enhanced performance. The novelty of this RF packages is three-fold: 1) Ultra-thin 100 μm glass, 2) Double-side thinfilm RF circuits interconnected with Through-Package Vias (TPVs), and 3) Direct assembly of the glass-core package to the board with Land Grid Array (LGA) connections. An innovative double-via process, starting from prefabricated vias in bare glass, polymer filling and via drilling, is utilized for a robust and high-yield substrate fabrication process. Scalable and low-cost panel laminate processes are utilized to form the RF circuits on the build-up layers. The performance benefits are demonstrated through interconnect loss, impedance match, electrical gain and noise figure measurements. Compared to existing RF substrates, the glass substrates show 2.5X miniaturization in substrate thickness with extensibility to thinner substrates.