What Makes an Intertrochanteric Fracture Unstable in 2015? Does the Lateral Wall Play a Role in the Decision Matrix?

作者：Akhil Tawari, Harish Kempegowda, Michael Suk, Daniel S. Horwitz · 发表于：Journal of Orthopaedic Trauma · 年份：2015 · DOI：10.1097/bot.0000000000000284 · 被引用次数：83 · 研究领域：Hip and Femur Fractures、Bone health and osteoporosis research、Bone and Joint Diseases

Intertrochanteric (IT) fractures pose a tremendous burden to the healthcare system. Although consistently good results are obtained while treating stable IT fractures, treatment failure rates with unstable fractures are much higher, and hence, it is imperative to identify unstable patterns. Presently, the conventionally classified unstable configurations (fracture with posteromedial comminution, reverse oblique, IT with subtrochanteric extension) and the recently added fracture patterns (IT fractures with avulsed greater trochanter and lateral wall breach) qualify as unstable IT fractures; however, the list is certainly not exhaustive. Disruption of lateral wall converts an IT fracture into a reverse oblique fracture equivalent and should be given a strong consideration in the decision matrix.