8 | RECOMMENTATION OF INTERNATIONAL AO FOUNDATION
Trochanteric fracture divides into 3 types [4]:
- Pertrochanteric, simple.
- Pertrochanteric, multi-fragmentary.
- Intertrochanteric.
Pertrochanteric, simple fractures : (Figue 7)
- These fractures cause significant shortening, but they are stable
after reduction and fixation, largely because of the excellent contact
of the fracture surfaces
- The lesser trochanter, the so-called medial buttress, is intact.
- These fractures may be treated with a sliding hip screw and plate, or
a cephalomedullary nail.
Pertrochanteric, multi-fragmentary fractures: (Figue 8)
- In multi-fragmentary per-trochanteric fractures the fracture line can
start laterally anywhere on the greater trochanter and runs towards
the medial cortex which is broken in two places. This results in the
detachment of a third fragment which includes the lesser trochanter.
- These fractures may be treated with a sliding hip screw and plate, or
a cephalomedullary nail
Intertrochanteric fractures: (Figue 9)
- True intertrochanteric fractures are subdivided according to the
fracture pattern. The fracture line passes between the two
trochanters, above the lesser trochanter medially and below the crest
of the vastus lateralis laterally. Both femoral cortices are involved.
- These fractures may be treated with a sliding hip screw and plate
(DCS), or a cephalomedullary nail.