Ji Wan Kim; Jae-Suk Chang; Jung Hwan Sung; Jung Jae Kim

doi:10.12671/jkfs.2013.26.3.173

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Original Article
The Character of Reverse Obliquity Intertrochanteric Fractures in Elderly Patients: Ji Wan Kim, M.D., Jae-Suk Chang, M.D., Jung Hwan Sung, M.D., Jung Jae Kim, M.D.; Journal of the Korean Fracture Society 2013;26(3):173-177.
DOI: https://doi.org/10.12671/jkfs.2013.26.3.173
Published online: July 15, 2013

Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

^*Department of Orthopaedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea.

Address reprint requests to: Jae-Suk Chang, M.D. Department of Orthopaedic Surgery, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Tel: 82-2-3010-3530·Fax: 82-2-488-7877, jschang@amc.seoul.kr

• Received: March 25, 2013 • Revised: May 12, 2013 • Accepted: June 11, 2013

This is anOpen Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To discriminate the characteristics between reverse obliquity fractures in the elderly and that of young adults using three-dimensional computed tomography (3D CT).
Materials and Methods
Eighteen patients who had reverse obliquity intertrochanteric fractures were enrolled from January 2007 to March 2012. The fracture pattern was analyzed using the 3D CT. The area showing low density (bone defect) of trochanter and femoral neck region was measured. Patients were divided into two groups: Group I, less than 65 years old and Group 2, 65 years and over.
Results
In all 9 cases of group 1, the proximal fragment had a 'V' shape with an average of 5.6 cm below the vastus ridge; however, the fracture of 8 cases (88.97%) in group 2 had a 'Λ' shape of the distal fragment at the level of vastus ridge and an additional fracture line extending to the greater trochanter tip. The bone defect volume of the trochanter and femoral neck region was larger significantly in group 2 than in group 1.
Conclusion
Reverse obliquity intertrochanteric fracture in the elderly demonstrated a pattern of bursting fracture with 4 parts, which had different patterns from that of young patients. We believe that the larger volume of bone defects resulted in the difference of fracture patterns between the two groups.
Key words: Femur, Hip fracture, Reverse obliquity fracture, Fracture pattern

REFERENCES

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Fig. 1

(A) Region of interest in trochanter from the greater trochanter tip to the upper part of lesser trochanter.

(B) Measurement of bone defect of the trochanter and femoral neck region.

Fig. 2

Three-dimensional image of reverse obliquity fracture in the young group (group 1).

(A) Anterior-posterior view showing a typical reverse obliquity pattern.

(B) Lateral view showing a 'V' shape apex of proximal fragment.

Fig. 3

Three-dimensional image of reverse obliquity fracture in the elderly group (group 2).

(A) Anterior-posterior view showing a typical reverse obliquity pattern with additional fracture line along the trochanteric line.

(B) Lateral view showing a 'Λ' shape apex of distal fragment and additional vertical splitting of the greater trochanter.

Table 1

Clinical Data between the Two Groups

Values are presented as average (range) or mean±standard deviation or average (%). BMD: Bone mineral density.

Figure & Data

REFERENCES

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Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
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The Character of Reverse Obliquity Intertrochanteric Fractures in Elderly Patients

J Korean Fract Soc. 2013;26(3):173-177. Published online July 31, 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.3.173

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The Character of Reverse Obliquity Intertrochanteric Fractures in Elderly Patients

Fig. 1 (A) Region of interest in trochanter from the greater trochanter tip to the upper part of lesser trochanter. (B) Measurement of bone defect of the trochanter and femoral neck region.

Fig. 2 Three-dimensional image of reverse obliquity fracture in the young group (group 1). (A) Anterior-posterior view showing a typical reverse obliquity pattern. (B) Lateral view showing a 'V' shape apex of proximal fragment.

Fig. 3 Three-dimensional image of reverse obliquity fracture in the elderly group (group 2). (A) Anterior-posterior view showing a typical reverse obliquity pattern with additional fracture line along the trochanteric line. (B) Lateral view showing a 'Λ' shape apex of distal fragment and additional vertical splitting of the greater trochanter.

Fig. 1

Fig. 2

Fig. 3

The Character of Reverse Obliquity Intertrochanteric Fractures in Elderly Patients

Table 1

Clinical Data between the Two Groups

Values are presented as average (range) or mean±standard deviation or average (%). BMD: Bone mineral density.

Table 1 Clinical Data between the Two Groups

Values are presented as average (range) or mean±standard deviation or average (%). BMD: Bone mineral density.