• Yasunari Ikuta, Yoshihiko Nagata, and Yoichi Iwasaki.
• Department of Orthopaedic Surgery, Hiroshima-Nishi Medical Center, Japan; Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan. Electronic address: yasunarikuta@gmail.com.
• Injury. 2019 Nov 1; 50 (11): 2014-2021.

IntroductionThe aim of this study was to clarify the relationship between the preoperative radiographic classification of trochanteric fractures and the success/failure of closed reduction. Identification of irreducible fractures would be important to proceed promptly to direct reduction.Patients And MethodsOur retrospective analysis included 141 trochanteric fractures, in 122 women and 17 men, with a mean age of 85.7 years (range, 45-101 years). Evans' classification of trochanteric fractures, as modified by Jensen, and the lateral view classification were used, based on preoperative plain radiographs and computed tomography images. Features predictive of irreducible fractures were identified.ResultsAmong the 141 fractures, 16 (11.3%) were irreducible by closed reduction. The position of the proximal fragment, relative to the shaft on lateral view, and the fracture pattern of the lesser and greater trochanters were predictive of the feasibility of obtaining a successful closed reduction. These criteria identified success/failure of closed reduction in 99.3% of cases.ConclusionOur findings should be useful for identifying patients in whom closed reduction would be suitable and for avoiding ineffectual manipulation in unsuitable patients.Copyright © 2019 Elsevier Ltd. All rights reserved.

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