Trochanteric Femoral Fracture Classification: Relevance of the Fracture Line Angle, a Radiological Study

Abstract

Aim: The aim of this study was to evaluate the trochanteric fracture line in terms of the fracture line angle and anatomical location. Methods: The preoperative AP radiographs of 164 randomly selected patients with trochanteric fractures were obtained. Measurements were made of: (1) the angle between the mid-shaft femoral axis and the fracture line, (2) the intersection point of the fracture line with the greater trochanter. Results: An increase in comminution correlated with an increased fracture line angle. The angle of the fracture line relative to the femoral shaft showed a mean of 43º (SD 10), but a range from 19º to 146º. Discussion: This study provides information on the fracture line properties of trochanteric fractures and demonstrates a massive range in fracture line inclination and fragment size. Theoretical Engineering modelling studies have indicated that the measurements described in this study will have a major bearing on fracture stability. These findings can be applied to improve classifications for stable and unstable trochanteric fractures.