Abstract

Purpose: The purpose of this study is to consider the complicated fracture line in trochanteric fractures of the femur by three-dimensional computed tomography (3DCT).
Methods: 80 cases of trochanteric fracture of the femur, Type 1 according to the Evans Classification were targeted and the fracture line of 80 joints was considered in detail by 3DCT.
Results: The fracture line of a trochanteric fracture is comprised of a primary fracture line which is considered to be the standard fracture line and a secondary fracture line which occurs afterwards. The anterior section of the primary fracture line runs from the trochanteric fossa in the frontward direction, passing through the lateral intertrochanteric eminence and then inward and downward along the intertrochanteric line. The posterior section of the primary fracture line occurs at the insertion of the ischiofemoral ligament adjacent to the trochanteric fossa and goes in the upward direction of the lesser trochanter along the intertrochanteric groove and connects to the anterior fracture line. In most cases of a secondary fracture line, the fracture runs from upper edge of the lateral intertrochanteric eminence outwardly, traveling from upper front of the greater trochanter towards the lesser trochanter, causing a greater trochanter fracture or lesser trochanter bone fragment.
Conclusion: The primary fracture line occurred along the attached area of the capsular ligaments. The posterior section of the primary fracture line is especially characteristic and is a very important factor in differentiating between a neck fracture and a subtrochanteric fracture.

Abbreviations:Trochanteric fracture of the femur; Fracture line; 3Dct