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Trauma: A. Alam, K. Willett, and S. Ostlere The MRI diagnosis and management of incomplete intertrochanteric fractures of the femur J Bone Joint Surg Br 2005; 87-B: 1253-1255 [Abstract] [Full text] [PDF]

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Incomplete intertrochanteric fractures

Harish V Kurup, Steve Sarasin, Andy McMurtrie   (26 October 2005)

Incomplete intertrochanteric fractures 26 October 2005
Harish V Kurup, Specialist Registrar in Orthopaedics Ysbyty Gwynedd, Bangor LL57 2PW, Steve Sarasin, Andy McMurtrie Send letter to journal: Re: Incomplete intertrochanteric fractures harishvk{at}yahoo.com Harish V Kurup, et al.	Sir, We read with interest the article on incomplete intertrochanteric fractures. With the relatively small number of patients in this study (5 treated conservatively and 3 operatively) it does not sound reassuring enough to us to adopt the author's conclusions. However we have some comments: 1. Patients who were treated conservatively in this series, have been treated so because of high anaesthetic risk. Still all were discharged in less than three weeks and were mobilising with support at that point. Some of them did survive long enough to be re-admitted in three years. Did any factor other than anaesthetic risk influence the decision on management in these patients that could have contributed to these good results? 2.The authors refer to the paper by Shultz et al1 suggesting operative treatment for fractures crossing the midsagittal line. Did the patients in the present series differ in the extent of fracture line with reference to the midsagittal line between the two groups? 3. Two of the relatively young patients managed surgically, when re-admitted at a later date, were noted to be still using walking aids. - Why? Harish Kurup Steve Sarasin Andy McMurtrie References: 1. Schultz E, Miller TT, Boruchov SD, Schmell EB, Toledano B. Incomplete intertrochanteric fractures: imaging features and clinical management. Radiology 1999;211:237-40.