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Incomplete Intertrochanteric Fracture: A Pattern Analysis Using Multiplanar Reformation Computed Tomography.

Hee Joong Kim¹, Jae Youn Yoon², Sunhyung Lee³

¹Department of Orthopedic Surgery, Yeson Hospital, Bucheon, Korea.

Clinics in Orthopedic Surgery

|September 5, 2022

Summary

This summary is machine-generated.

Incomplete intertrochanteric fractures (IIFs) often present as isolated greater trochanter fractures (GTFs). Multiplanar reformation CT (MPR CT) confirms anterior cortical breakage in IIFs, distinguishing them from posterior-to-anterior extensions seen in GTFs.

Keywords:

Incomplete Intertrochanteric fracture Pattern analysis Three-dimensional computed tomography

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Area of Science:

Orthopedic Surgery
Radiology
Traumatology

Background:

Incomplete intertrochanteric fractures (IIFs) are rarely reported, often mistaken for isolated greater trochanter fractures (GTFs).
Previous definitions linked IIFs to intertrochanteric extension on MRI in GTFs.
This study investigates IIFs and apparently isolated GTFs using advanced imaging.

Purpose of the Study:

To evaluate incomplete intertrochanteric fractures (IIFs) and apparently isolated greater trochanter fractures (GTFs).
To analyze the fracture patterns of IIFs confirmed by multiplanar reformation computed tomography (MPR CT).
To differentiate IIFs from other fracture types using MPR CT.

Main Methods:

Retrospective analysis of 36 IIF cases detected via MPR CT between 2006 and 2019.
Evaluation of plain radiographs and MPR CT images by orthopedic surgeons.
Magnetic resonance (MR) imaging performed in 5 cases for further characterization.

Main Results:

MPR CT confirmed incomplete cortical breakage in the intertrochanteric area in all 36 IIF cases.
Cortical breakage was consistently located in the anterior portion, with the posterior cortex intact.
MR imaging revealed intertrochanteric extensions originating from the greater trochanter, extending anteriorly and inferomedially.

Conclusions:

Incomplete intertrochanteric fractures (IIFs) are characterized by anterior cortical breakage in the proximal femur.
This anterior breakage pattern in IIFs is distinct from the posterior-to-anterior intertrochanteric extension seen in isolated GTFs.
MPR CT is crucial for accurately diagnosing and characterizing IIFs.