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Preoperative radiographic features of trochanteric fractures irreducible by closed reduction

Injury Jul 17, 2019

Ikuta Y, et al. - Researchers retrospectively analyzed 141 trochanteric fractures, in 122 women and 17 men [mean age: 85.7 years (range, 45-101 years)]. in order to clarify how the preoperative radiographic classification of trochanteric fractures determines the success/failure of closed reduction. In addition, they sought for features predictive of irreducible fractures considering the significance of the prompt direct reduction in these fractures. Based on preoperative plain radiographs and computed tomography images, they used Evans’ classification of trochanteric fractures, as modified by Jensen, and the lateral view classification. Irreducible by closed reduction in 16 (11.3%) was reported. The feasibility of obtaining a successful closed reduction could be predicted by assessing the position of the proximal fragment, relative to the shaft on lateral view, and the fracture pattern of the lesser and greater trochanters. Identification of success/failure of closed reduction in 99.3% of cases was made using these criteria.
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