Background: This case report presents an open subtrochanteric fracture in a premature low birth weight newborn, which was treated with intramedullary Kirschner wire. Methods: A neonate with left open subtrochanteric fracture was referred to the orthopedics department of the current study. Pavlik harness was applied yet treatment failed; therefore, an intramedullary Kirschner wire was applied. Results: The pin wasmaintained for 6 weeks and fracture healing was confirmed by a radiograph. Follow up after 18months showed complete healing, no limb length discrepancy, and normal gait. Conclusions: In some patients, traditional methods, such as traction, cast, and Pavlik harness cannot be used. Intramedullary Kirschner wire insertion could be an alternative treatment option.