Morphology and fixation pitfalls of a highly unstable intertrochanteric fracture variant

Journal of Orthopaedic Surgery
B Y TanE Bk Kwek

Abstract

To describe a variant of intertrochanteric fracture not well-characterised in the existing classification systems. 10 women and 2 men aged 59 to 98 (median, 80) years with intertrochanteric fractures characterised by a low intertrochanteric fracture, a basicervical fracture fragment, and a thin or fractured lateral wall with greater trochanteric comminution were reviewed. The 12 fractures were classified as A2.1 (n=1), A2.2 (n=7), A2.3 (n=1), and A3 (n=3) according to the AO/OTA classification, and as type 3 (n=2), type 5 (n=7), and type 6 (n=3) according to the Evans classification. The fractures were characterised by greater trochanter comminution and a coronal plane fracture extending into the greater trochanter resulting in a loss of superolateral support. Patients were treated with the Proximal Femoral Nail Antirotation (n=5), the Proximal Femur Locking Plate (n=6), or the reversed Less Invasive Stabilization System for distal femur (n=1). Within the mean follow-up period of 6 months, 3 patients with plating and one patient with nailing had mechanical failure defined as loss of alignment of >10º or screw cutout. This intertrochanteric fracture variant is highly unstable with a high failure rate. Loss of superolateral suppo...Continue Reading

References

May 1, 2001·Acta Orthopaedica Scandinavica·I B SchipperA B van Vugt
Apr 6, 2007·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Wayne FungMohit Bhandari
Jun 1, 1949·Archives of Surgery·H B BOYD, L L GRIFFIN
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Aug 25, 2010·Archives of Orthopaedic and Trauma Surgery·David J Hak, Christian Bilat
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