J Korean Hip Soc.  2010 Mar;22(1):1-12. 10.5371/jkhs.2010.22.1.1.

Surgical Treatment of Femur Intertrochanteric and Subtrochanteric Fracture

• Kim JO
• Kim TH

• KMID: 1461071
• DOI: http://doi.org/10.5371/jkhs.2010.22.1.1

Abstract

Femur intertrochanteric and subtrochanteric fractures are extracapsular hip fractures and they show a bimodal age distribution. Most hip fractures in young patient are subtrochanteric or basicervical fractures that are caused by high energy injury. Most of the hip fractures in old patients are intertrochanteric fractures related to osteoporosis and low energy injury. For proximal hip fractures, the muscles around the hip joint make reduction difficult and the position of the lag screws affects healing of the fracture. To lower the complications of these fractures, surgeons can use an appropriate implant along with performing good reduction and good lag screw positioning. We report here on our review of femur intertrochanteric and subtrochanteric fractures, the characteristics of compression hip screws, the intramedullary devices and the technical pitfalls.

Keyword

Femur; Intertrochanteric fracture; Subtrochanteric fracture; Compression hip screw; Intramedullary device

MeSH Terms

Age Distribution
Femur
Hip
Hip Fractures
Hip Joint
Humans
Muscles
Osteoporosis

Figure

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  Fig. 1 Boyd and Griffin classification.

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  Fig. 2 Evans classification.

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  Fig. 3 OTA/AO classification.

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  Fig. 4 Trochanteric stabilizaing plate.

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  Fig. 5 Intramedullary device (A) Gamma nail (B) Intertrochanteric/Subtrochanteric nail (ITST) (C) Proximal Femoral Nail (PFN) (D) Proximal Femoral Nail-Antirotaion (PFNA).

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  Fig. 6 Z-effect.

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  Fig. 7 Fielding classification.

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  Fig. 8 Seinsheimer classification.

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  Fig. 9 Russel-Taylor classification.

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  Fig. 10 AO/ASIF classification.

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  Fig. 11 Deforming forces about a subtrochanteric femur fracture.

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  Fig. 12 Kuntscher technique.

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