Li P, Lv Y, Zhou F, et al. - In this study, a classification for medial wall fragments was introduced in pertrochanteric femur fractures and evaluated potential preoperative prognosticators of implant failure following fixation. Researchers retrospectively analyzed medical records of 324 adult patients who received routine operative treatment using intramedullary devices for pertrochanteric femur fractures with medial wall fragments between August 2008 and May 2018. They recorded potential predictors including age, gender, body mass index, comorbidities, AO/OTA classification of fractures. They classified medial wall fractures into three types (type I: avulsion of the lesser trochanter; fracture line does not exceed the base of the lesser trochanter, type II: fragment involving the posterior cortex near the base of the lesser trochanter; fracture line does not reach the midline of the posterior wall and type III: fragment involving the large posterior cortex; fracture line reaches or exceeds the midline of the posterior wall). This study's finding demonstrate that type III fractures had a significantly increased failure rate. Presurgically identification of Type III fractures is important for orthopedists, using intramedullary nails, reduction of the medial wall fragment and fixation should be considered during surgery.