IT Fracture Classification

Stable fracture

• posteromedial cortex intact/minimal comminution
• Treatment = 2-hole DHS.
• Tip-apex distance shoulde be equal to or less than 25mm (tip apex distance = the sum of the distance from the tip of the lag screw to the apex of the femoral head on the AP and lateral Xrays) (Baumgaertner MR, JBJS 1995; 77:1058)
• See also AO Classification.

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Biomet Hip Screw

Dupuy TiMax

EBI PTN Nail (T)

EBI VHS

Gotfried PC.C.P

Orthofix Veronail(T)

Smi&Neph IMHS (T)

Smi&Neph CHS (T)

Styker Gamma3 (V)

Styker Omega

Synthes Helical Hip Screw (T)

Synthes DHS/DCS

Unstable fracture

• posteromedial cortex comminuted, lateral cortex disruption.
• Treatment = IMHS. Generally with long unlocked nail, unless there is subtrochanteric extention.
• Distal locking indicated for fractures with subtroch extention.
• Increased failure/complications rate as compared to stable fractures.
• See also AO Classification.

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Reverse oblique

• 5% of all IT/subtrochanteric fxs)
• Treatment = IMHS with distal locking are indicated or  95 degree fixed-angle device . (Haidukewych JBJS 2001;83A:643)
• Sliding hip screw is associated with many complications and failures.
• See also AO Classification.

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