Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area
Purpose. Proximal femoral fractures involving both the subcapital area and the trochanteric or subtrochanteric area have rarely been reported, but they are not uncommon. However, few studies have reported the incidence or clinical outcomes of such fractures. This study investigated such fractures. M...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2019/1628683 |
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| author | Takayuki Tani Hiroaki Kijima Natsuo Konishi Hitoshi Kubota Shin Yamada Hiroshi Tazawa Norio Suzuki Keiji Kamo Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Yosuke Iwamoto Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada |
| author_facet | Takayuki Tani Hiroaki Kijima Natsuo Konishi Hitoshi Kubota Shin Yamada Hiroshi Tazawa Norio Suzuki Keiji Kamo Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Yosuke Iwamoto Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada |
| author_sort | Takayuki Tani |
| collection | DOAJ |
| description | Purpose. Proximal femoral fractures involving both the subcapital area and the trochanteric or subtrochanteric area have rarely been reported, but they are not uncommon. However, few studies have reported the incidence or clinical outcomes of such fractures. This study investigated such fractures. Methods. In area classification, the proximal femur is divided into 4 areas by 3 boundary planes: the first plane is the center of femoral neck; the second plane is the border between femoral neck and femoral trochanter; and the third plane links the inferior borders of greater and lesser trochanters. A fracture only in the first area is classified as a Type 1 fracture; one in the first and second areas is classified as a Type 1-2 fracture. Therefore, proximal femoral fractures involving both the subcapital area and the trochanteric area are classified as Type 1-2-3, and those involving both the subcapital area and the subtrochanteric area are classified as Type 1-2-3-4. In this study, a total of 1042 femoral proximal fractures were classified by area classification, and the treatment methods and the failure rates were investigated only for Types 1-2-3 and 1-2-3-4 cases. The failure rate was defined as the incidence of internal fixator cut-out or telescoping >10 mm. Results. Types 1-2-3 and 1-2-3-4 fractures accounted for 1.72%. Surgical treatment was performed for 89%. Of these, 56% underwent osteosynthesis, but the failure rate was 33%. The other patients (44%) underwent prosthetic replacement. Fracture lines of all these fractures were present along trochanteric fossa to intertrochanteric fossa in posterior aspect and just below the femoral head in anterior aspect. Conclusion. Fracture involving the subcapital area to the trochanteric or subtrochanteric area was found in approximately 2%. In patients for whom prosthetic replacement was selected, good results were obtained. However, 1/3 of patients who underwent osteosynthesis had poor results. |
| format | Article |
| id | doaj-art-ad3c12999ace434484f8ed786d5eb978 |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-ad3c12999ace434484f8ed786d5eb9782025-02-03T01:24:20ZengWileyAdvances in Orthopedics2090-34642090-34722019-01-01201910.1155/2019/16286831628683Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric AreaTakayuki Tani0Hiroaki Kijima1Natsuo Konishi2Hitoshi Kubota3Shin Yamada4Hiroshi Tazawa5Norio Suzuki6Keiji Kamo7Yoshihiko Okudera8Masashi Fujii9Ken Sasaki10Tetsuya Kawano11Yosuke Iwamoto12Itsuki Nagahata13Naohisa Miyakoshi14Yoichi Shimada15Akita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, Hondo, Akita 010-8543, JapanAkita Hip Research Group, Akita 010-8543, JapanPurpose. Proximal femoral fractures involving both the subcapital area and the trochanteric or subtrochanteric area have rarely been reported, but they are not uncommon. However, few studies have reported the incidence or clinical outcomes of such fractures. This study investigated such fractures. Methods. In area classification, the proximal femur is divided into 4 areas by 3 boundary planes: the first plane is the center of femoral neck; the second plane is the border between femoral neck and femoral trochanter; and the third plane links the inferior borders of greater and lesser trochanters. A fracture only in the first area is classified as a Type 1 fracture; one in the first and second areas is classified as a Type 1-2 fracture. Therefore, proximal femoral fractures involving both the subcapital area and the trochanteric area are classified as Type 1-2-3, and those involving both the subcapital area and the subtrochanteric area are classified as Type 1-2-3-4. In this study, a total of 1042 femoral proximal fractures were classified by area classification, and the treatment methods and the failure rates were investigated only for Types 1-2-3 and 1-2-3-4 cases. The failure rate was defined as the incidence of internal fixator cut-out or telescoping >10 mm. Results. Types 1-2-3 and 1-2-3-4 fractures accounted for 1.72%. Surgical treatment was performed for 89%. Of these, 56% underwent osteosynthesis, but the failure rate was 33%. The other patients (44%) underwent prosthetic replacement. Fracture lines of all these fractures were present along trochanteric fossa to intertrochanteric fossa in posterior aspect and just below the femoral head in anterior aspect. Conclusion. Fracture involving the subcapital area to the trochanteric or subtrochanteric area was found in approximately 2%. In patients for whom prosthetic replacement was selected, good results were obtained. However, 1/3 of patients who underwent osteosynthesis had poor results.http://dx.doi.org/10.1155/2019/1628683 |
| spellingShingle | Takayuki Tani Hiroaki Kijima Natsuo Konishi Hitoshi Kubota Shin Yamada Hiroshi Tazawa Norio Suzuki Keiji Kamo Yoshihiko Okudera Masashi Fujii Ken Sasaki Tetsuya Kawano Yosuke Iwamoto Itsuki Nagahata Naohisa Miyakoshi Yoichi Shimada Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area Advances in Orthopedics |
| title | Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area |
| title_full | Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area |
| title_fullStr | Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area |
| title_full_unstemmed | Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area |
| title_short | Incidence and Clinical Outcomes of Hip Fractures Involving Both the Subcapital Area and the Trochanteric or Subtrochanteric Area |
| title_sort | incidence and clinical outcomes of hip fractures involving both the subcapital area and the trochanteric or subtrochanteric area |
| url | http://dx.doi.org/10.1155/2019/1628683 |
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