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Yao Z, Fan S, Zhao W, Huang J. The History of Classification Systems for Periprosthetic Femoral Fractures: A Literature Review. Orthop Surg 2024; 16:1816-1831. [PMID: 38946014 PMCID: PMC11293929 DOI: 10.1111/os.14149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/02/2024] [Accepted: 06/11/2024] [Indexed: 07/02/2024] Open
Abstract
Periprosthetic femoral fractures (PPFFs) following total hip arthroplasty (THA) present a significant clinical challenge due to their increasing incidence with an aging population and evolving surgical practices. Historically, classifications were primarily based on anatomical fracture location, the stability of the implant, and bone quality surrounding the implant. We critically analyzed 25 classification systems, highlighting the emergence and adaptations of key systems such as the Vancouver classification system (VCS) and the Unified classification system (UCS), which are lauded for their simplicity and effectiveness yet require further refinement. VCS, developed in 1995, categorizes fractures based on the site, implant stability, and bone quality, and remains widely used due to its robust applicability across different clinical settings. Introduced in 2014, UCS expands the VCS to encompass all periprosthetic fractures with additional fracture types, aiming for a universal application. Despite their widespread adoption, these systems exhibit shortcomings, including the incomplete inclusion of all PPFF types and the imprecise assessment of implant stability and surrounding bone loss. These gaps can result in misclassification and suboptimal treatment outcomes. This paper suggests the necessity for ongoing improvements in classification systems to include emerging fracture types and refined diagnostic criteria, ensuring that they remain relevant to contemporary orthopedic practices and continue to facilitate the precise tailoring of treatment to patient-specific circumstances. This comprehensive historical review serves as a foundation for future innovations in classification systems, ultimately aiming to standardize PPFF treatment and improve patient prognosis.
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Affiliation(s)
- Zhi‐Yuan Yao
- Department of Orthopaedics & TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)HangzhouChina
- The First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
| | - Shu‐Yao Fan
- The First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
- Department of Breast SurgeryThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)HangzhouChina
| | - Wei‐Qiang Zhao
- Department of Orthopaedics & TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)HangzhouChina
- The First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
| | - Jie‐Feng Huang
- Department of Orthopaedics & TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)HangzhouChina
- The First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
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Weissman BN, Palestro CJ, Fox MG, Bell AM, Blankenbaker DG, Frick MA, Jawetz ST, Kuo PH, Said N, Stensby JD, Subhas N, Tynus KM, Walker EA, Kransdorf MJ. ACR Appropriateness Criteria® Imaging After Total Hip Arthroplasty. J Am Coll Radiol 2023; 20:S413-S432. [PMID: 38040462 DOI: 10.1016/j.jacr.2023.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
This article reviews evidence for performing various imaging studies in patients with total hip prostheses. Routine follow-up is generally performed with radiography. Radiographs are also usually the initial imaging modality for patients with symptoms related to the prosthesis. Following acute injury with pain, noncontrast CT may add information to radiographic examination regarding the presence and location of a fracture, component stability, and bone stock. Image-guided joint aspiration, noncontrast MRI, and white blood cell scan and sulfur colloid scan of the hip, are usually appropriate studies for patients suspected of having periprosthetic infection. For evaluation of component loosening, wear, and/or osteolysis, noncontrast CT or MRI are usually appropriate studies. Noncontrast MRI is usually appropriate for identifying adverse reaction to metal debris related to metal-on-metal articulations. For assessing patients after hip arthroplasty, who have trochanteric pain and nondiagnostic radiographs, ultrasound, or MRI are usually appropriate studies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | | | | | - Angela M Bell
- Rush University Medical Center, Chicago, Illinois; American College of Physicians
| | - Donna G Blankenbaker
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | | | - Phillip H Kuo
- University of Arizona, Tucson, Arizona; Commission on Nuclear Medicine and Molecular Imaging
| | - Nicholas Said
- Duke University Medical Center, Durham, North Carolina
| | | | | | - Katherine M Tynus
- Northwestern Memorial Hospital, Chicago, Illinois; American College of Physicians
| | - Eric A Walker
- Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania; Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Sim JA, Shon OJ, Joo YB, Sohn HS, Byun SE, Kim JW. Clinical outcomes of osteosynthesis of well-fixed periprosthetic proximal tibial fractures (Felix type 2A) after total knee arthroplasty. Injury 2021; 52:3099-3103. [PMID: 34253352 DOI: 10.1016/j.injury.2021.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 02/02/2023]
Abstract
AIMS This study aimed to evaluate the clinical and radiologic outcomes of well-fixed periprosthetic tibial fractures after TKA. PATIENTS AND METHODS The medical records of patients who presented with Felix type 2A periprosthetic tibial fractures after TKA between March 2015 and February 2020 were retrospectively obtained from 5 institutions. Data on injury mechanism, fracture pattern including open fractures and Felix classification, and surgical method were recorded. Functional outcomes including range of motion (ROM) and Knee Society Score (KSS) at postoperative 1 year were reviewed. The need for reoperation was also reviewed. Radiologic findings included union time and mechanical proximal tibial angle (MPTA) at the last radiologic follow-up. RESULTS Eighteen patients (13 women, 5 men; average age, 73.9 years) were included. The average follow-up duration was 20.8 months. The fractures resulted from high-energy (11 cases) and low-energy (7 cases) injuries. Two cases involved open fractures. Anatomical locking plates were used in all cases: single plate (4 cases) and dual plates (14 cases). The average number of proximal screws was 7.1 (range, 4-9). All patients achieved bone union at an average of 18.6 weeks without secondary intervention. No infection occurred; however, 1 patient with skin necrosis required local flap. Implant removal was performed in 5 cases: 1 case, skin defect and 4 cases, discomfort due to plate prominence. The average ROM and KSS were 120.3° and 85.9, respectively. The mean MPTA was 87.8°; the MPTA was higher in the single-plate group (94.0° vs. 88.1°, p=0.013). Three cases involved values beyond the normal MPTA range (85-90°): 104° and 96° with a single plate and 92° with dual plates. The malalignment rate was higher in the single-plate group (p=0.043). CONCLUSION Felix type 2A periprosthetic tibial fractures treated with minimally invasive osteosynthesis showed excellent clinical outcomes, and tibial alignment was well maintained in the dual-plate group.
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Affiliation(s)
- Jae-Ang Sim
- Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Oog-Jin Shon
- Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Yong Bum Joo
- Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Hoon-Sang Sohn
- Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seong-Eun Byun
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505,Republic of Korea.
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Atypical periprosthetic femoral fractures after arthroplasty for fracture are at high risk of complications. Sci Rep 2021; 11:14378. [PMID: 34257322 PMCID: PMC8277775 DOI: 10.1038/s41598-021-93574-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
It is difficult to investigate clinical features in a single-center study because atypical periprosthetic femoral fracture (APFF) is rare. This study aims to perform a nationwide survey of APFF to investigate the characteristics of this fracture and compare the clinical outcome with that of typical periprosthetic femoral fracture (typical PFF). A nationwide survey was performed asking for cooperation from 183 councilors of the Japanese Society for Fracture Repair. The subjects were patients with APFF injured between 2008 and 2017. The control group was comprised of patients with typical PFF of our facility injured in the same period. A total of 43 patients met the APFF definition. The control group was comprised of 75 patients with typical PFF. The rate of bisphosphonate use was significantly higher in the APFFs group than in the typical PFF group (62.8% and 32%, p < 0.02). The rate of cemented stem was significantly higher in the APFFs group than in the typical PFF group (30.2% and 6.7%, p < 0.001). In the patients with arthroplasty for hip fracture, multivariable logistic regression analyses showed that APFF was an independent risk factor of complications following the initial management (Odds ratio 11.1, 95% confidence interval 1.05–117.2, p = 0.045). However, no significant association between PFF and APFF was observed in the patients with arthroplasty for other hip diseases. The risk of complications was higher in the APFF group than in the typical PFF group in the patients with arthroplasty for fracture. When AFPP after arthroplasty for the fracture is suspected, it may be necessary to add not only internal fixation with a normal plate but also some additional treatment.
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Rupp M, Kern S, Ismat A, El Khassawna T, Knapp G, Szalay G, Heiss C, Biehl C. Computed tomography for managing periprosthetic femoral fractures. A retrospective analysis. BMC Musculoskelet Disord 2019; 20:258. [PMID: 31138187 PMCID: PMC6540448 DOI: 10.1186/s12891-019-2632-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background Periprosthetic fractures (PPF) present a common cause for revision surgery after arthroplasty. The choice of performing either an osteosynthesis or revision arthroplasty depends on the orthopedic implant anchored and loosening. Standard diagnostics include x-ray imaging. CT is usually performed to confirm implant loosening in case of ambiguous diagnosis on standard x-ray imaging. This study aimed to examine the role of CT as a diagnostic modality and its implications for treatment planning and outcome. Methods Patients treated for PPF from January 2010 to February 2018 were included. X-ray and CT reports were analyzed to assess implant loosening. The planning for surgery and the final surgical treatment were evaluated. In addition, patient characteristics were analyzed and compared between patients with and without additional CT as a preoperative diagnostic procedure. Results Seventy-five patients were eligible for the study. X-ray imaging was performed in 90.7% of cases. CT was performed in 60% of the cases as part of the preoperative diagnostic. A clear statement on implant stability or loosening could not be made in 69.1% after X-ray imaging and in 84.4% following CT imaging. Revision arthroplasty for loosened femoral prosthesis components was necessary in 40% of cases. No difference could be determined comparing patients with X-ray imaging to those with X-ray and additional CT. In both groups, operative treatment did not deviate from the preoperative planning. Discussion In two thirds of the conventional radiographic findings, no reliable evaluation of implant loosening was possible in femoral PPFs. Intriguingly, additional CT did not improve the evaluation of implant loosening. Nonetheless, CT scans are often performed if loosening assessment is unclear on regular radiographs. This fact can explain the bias CT results in comparison to regular radiography. However, software-supported CT diagnosis could help to adequately answer the question of loosened implants in PPF in the near future. Since the diagnosis of fracture and their morphology assessment is currently adequately performed using X-rays, CT shall not be considered as the gold standard.
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Affiliation(s)
- Markus Rupp
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany. .,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany.
| | - Stefanie Kern
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Abdullah Ismat
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany.,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Gero Knapp
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany.,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Gabor Szalay
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany.,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Christian Heiss
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany.,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
| | - Christoph Biehl
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital of Giessen-Marburg, Giessen, Germany.,Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University of Giessen, Giessen, Germany
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Tosounidis TH, Giannoudis PV. Osteosynthesis of interprosthetic fractures: Evidence and recommendations. Injury 2018; 49:2097-2099. [PMID: 30526919 DOI: 10.1016/j.injury.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Theodoros H Tosounidis
- Department of Orthopaedic Surgery, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece.
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, School of Medicine, University of Leeds, Leeds, United Kingdom; NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, United Kingdom.
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Abstract
Periprosthetic fractures around total knee arthroplasty have become an increasingly common and challenging orthopaedic problem. Appropriate management of these fractures depends on careful scrutiny of radiographs and a thorough clinical history to exclude the diagnosis of a periprosthetic infection. In a periprosthetic tibial fracture with a stable, well-aligned tibial component and well-aligned mechanical tibial axis, the fracture can be successfully managed with closed reduction and cast immobilization; meticulous follow-up is essential to ensure that the alignment is maintained. Major fracture displacement, tibial component instability, and tibial component malalignment are all indications for surgical intervention. The ideal surgical intervention depends on the fracture characteristics and the stability and alignment of the tibial component.
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Gao Z, Lv Y, Zhou F, Ji H, Tian Y, Zhang Z, Guo Y. Risk factors for implant failure after fixation of proximal femoral fractures with fracture of the lateral femoral wall. Injury 2018; 49:315-322. [PMID: 29274656 DOI: 10.1016/j.injury.2017.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/09/2017] [Accepted: 11/14/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION To investigate potential predictors of implant failure following fixation of proximal femoral fractures with a fracture of the lateral femoral wall. MATERIALS AND METHODS Medical records of 99 adult patients who had operative treatment for a proximal femoral fracture with a fracture of the lateral femoral wall between May 2004 and April 2015 were retrospectively analysed to determine factors associated with implant failure. Patients underwent routine surgical procedures for implantation of extramedullary or intramedullary devices. Potential predictors were age, gender, body mass index, comorbidities, type of fracture, reduction method, status of greater and lesser trochanters, course of the lateral fracture line, and presence/absence of a free bone fragment at the junction of the greater trochanter and lateral femoral wall. RESULTS Ten (10%) implant failures were identified. Univariate analysis identified a free bone fragment at the junction of the greater trochanter and lateral femoral wall (odds ratio [OR], 21.25; 95% confidence interval [CI], 4.31-104.67; p < 0.001) and a transverse fracture line across the lateral femoral wall (primary or iatrogenic) (OR, 5.36; 95% CI, 1.29-22.30; p = 0.021) as factors associated with implant failure. Using a multivariate model, only a free bone fragment at the junction of the greater trochanter and lateral femoral wall (OR, 16.05; 95% CI, 3.06-84.23; p = 0.001) was a risk factor for implant failure. CONCLUSIONS A free bone fragment at the junction of the greater trochanter and lateral femoral wall and a transverse fracture line across the lateral femoral wall are predictors of implant failure in proximal femoral fractures with a fracture of the lateral femoral wall. Integrity of the lateral femoral wall correlates with prognosis of proximal femoral fracture. Lateral femoral wall reconstruction may be required for effective treatment of proximal femoral fractures with a fracture of the lateral femoral wall.
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Affiliation(s)
- Zhechen Gao
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191.
| | - Yang Lv
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191.
| | - Fang Zhou
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191.
| | - Hongquan Ji
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191
| | - Yun Tian
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191
| | - Zhishan Zhang
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191
| | - Yan Guo
- Department of Orthopedics, Peking University Third Hospital, No 49, North Garden Rd, Haidian District, Beijing, China 100191
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The Baba classification focused on implant designs is useful in setting the therapeutic strategy for interprosthetic femoral fracture. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 28:247-254. [DOI: 10.1007/s00590-017-2045-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/10/2017] [Indexed: 10/18/2022]
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Futamura K, Baba T, Homma Y, Mogami A, Kanda A, Obayashi O, Sato K, Ueda Y, Kurata Y, Tsuji H, Kaneko K. New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures. Injury 2016; 47:1685-91. [PMID: 27242330 DOI: 10.1016/j.injury.2016.05.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 04/24/2016] [Accepted: 05/09/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE There are various types of intertrochanteric fractures that are unstable pertrochanteric fractures of the hip. The aim of this study was to develop a systematic and comprehensive classification of intertrochanteric fractures. MATERIALS AND METHODS This study enrolled 74 patients with intertrochanteric fractures treated by us between 2012 and 2015. The fractures were classified using 3D-CT images taken immediately after the fractures occurred based on the course of the lateral fracture line (LFL) that extends through the lateral femoral cortex distal to the vastus ridge of the greater trochanter in the intertrochanteric area. Furthermore, the presence or absence of additional typical fractures was also studied. Then, 4 orthopedic specialists examined the 3D-CT images of 20 patients randomly selected from the 74 patients to evaluate both the inter-rater and intra-rater agreement levels. RESULTS Intertrochanteric fractures were classified into three types according to the LFL patterns. Type I (41.9%), the Lateral Wall Pattern, has a LFL that extends towards the lateral fiber bundle attachment area of the iliofemoral ligament. Type II (24.3%), the Transverse Pattern, has a LFL that extends towards the medial bundle attachment area. Type III (33.8%), the Reverse Oblique Pattern, has a LFL that extends between the lateral and medial fiber bundle area of the iliofemoral ligament. Each type showed characteristic displacement and was associated with various combinations of typical fractures (fracture across the intertrochanteric line, posteromedial fragment, including the lesser trochanter, posterolateral fragment posterior to the femoral greater trochanter, and banana-shaped big fragment, including both the greater trochanter and the lesser trochanter). The mean κ values for the interobserver and intraobserver agreement levels were 0.77 (0.70-0.85) and 0.76 (0.70-0.85), respectively, which were considered substantial agreement levels. CONCLUSION We believe our new classification is a useful communication tool for medical professionals in the diagnosis of fractures.
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Affiliation(s)
- Kentaro Futamura
- Department of Orthopedic Surgery, Juntendo University Shizuoka Hospital, 1129 nagaoka, Izunokuni-shi, Shizuoka, Japan
| | - Tomonori Baba
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Yasuhiro Homma
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Atsuhiko Mogami
- Department of Orthopedic Surgery, Juntendo University Shizuoka Hospital, 1129 nagaoka, Izunokuni-shi, Shizuoka, Japan
| | - Akio Kanda
- Department of Orthopedic Surgery, Juntendo University Shizuoka Hospital, 1129 nagaoka, Izunokuni-shi, Shizuoka, Japan
| | - Osamu Obayashi
- Department of Orthopedic Surgery, Juntendo University Shizuoka Hospital, 1129 nagaoka, Izunokuni-shi, Shizuoka, Japan
| | - Kazuo Sato
- Orthopedic Trauma Center, Sapporo Tokushukai Hospital, 1-1-1Oyachihigashi, Atsubetsu-ku, Sapporoshi, Hokkaido, Japan
| | - Yasuhisa Ueda
- Orthopedic Trauma Center, Sapporo Tokushukai Hospital, 1-1-1Oyachihigashi, Atsubetsu-ku, Sapporoshi, Hokkaido, Japan
| | - Yoshiaki Kurata
- Orthopedic Trauma Center, Sapporo Tokushukai Hospital, 1-1-1Oyachihigashi, Atsubetsu-ku, Sapporoshi, Hokkaido, Japan
| | - Hideki Tsuji
- Orthopedic Trauma Center, Sapporo Tokushukai Hospital, 1-1-1Oyachihigashi, Atsubetsu-ku, Sapporoshi, Hokkaido, Japan
| | - Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Hamadouche M, Stern LLD. Periprosthetic fractures and complicated arthroplasties. INTERNATIONAL ORTHOPAEDICS 2015; 39:1671-2. [PMID: 26278676 DOI: 10.1007/s00264-015-2977-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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