How can MRI change the treatment strategy in apparently isolated greater trochanteric fracture?
Injury
; 49(4): 824-828, 2018 Apr.
Article
en En
| MEDLINE
| ID: mdl-29566988
ABSTRACT
INTRODUCTION:
The purpose of this study was to evaluate the proportion of greater trochanter (GT) fractures with occult extension to the intertrochanteric region on magnetic resonance imaging (MRI) among apparently isolated GT fractures and to investigate the use of MRI for formulating a treatment strategy in patients with isolated GT fractures. PATIENTS ANDMETHODS:
This retrospective cohort study reviewed 37 patients with isolated GT fractures on plain radiography. Surgical or conservative treatment was decided according to MRI findings. We divided patients into 3 groups according to the extension of the fracture line. In group 1, the fracture line was within the lateral one-third in the coronal plane. In group 2, the fracture line extended from the lateral one-third to the medial one-third. In group 3, the fracture line extended over the medial one-third and/or to the medial cortex of the femur. Conservative treatment was performed in groups 1 and 2, and surgical treatment was performed in group 3. The clinical results, radiography findings, and MRI findings were investigated.RESULTS:
MRI revealed hidden intertrochanteric fractures (groups 2 [nâ¯=â¯10] and 3 [nâ¯=â¯4]) in 38% of apparently isolated GT fractures on radiography. No displacement was found in groups 1 (nâ¯=â¯23) and 2. Of the 4 patients in group 3, 3 were treated surgically and achieved good functional results and 1 refused to undergo surgery and finally developed complete intertrochanteric fracture. This patient presented 5â¯days later with increased hip pain, and radiography demonstrated displacement of the fracture, prompting surgical intervention.CONCLUSIONS:
The evaluation of apparently isolated GT fractures using MRI can be useful to diagnose the extent of the occult fracture and determine the treatment strategy.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Soporte de Peso
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Curación de Fractura
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Fémur
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Fijación Intramedular de Fracturas
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Fracturas Cerradas
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Fracturas de Cadera
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Injury
Año:
2018
Tipo del documento:
Article