title: Multiplanar reformation computed tomogram is better than MR imaging in decision making for apparently isolated fractures of the greater trochanter.
abstract: OBJECTIVE
  We evaluated isolated fractures of the greater trochanter (IFGT) on plain radiographs with multiplanar reformation computed tomography (MPR CT).
  
  
  METHODS
  Retrospective review of patients.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  This study included 27 consecutive patients with apparently IFGT.
  
  
  METHODS
  The clinical results, X-ray, computed tomography, magnetic resonance imaging, bone scintigraphy findings were investigated.
  
  
  RESULTS
  Four of 27 cases demonstrated anterior cortical breakage or extensive damage of the trabecular bone in the intertrochanteric area on MPR CT images. Surgical fixation was necessary for these 4 cases. The other 23 cases, in which no structural damage was detected, were treated conservatively, and the results were satisfactory without progression to a complete intertrochanteric fracture. All 9 cases evaluated with magnetic resonance imaging demonstrated extension into the intertrochanteric area. In 5 cases, the extension crossed the midline on the mid-coronal image. Two of the cases were treated surgically because of anterior cortical breakage and extensive trabecular impaction on MPR CT, respectively. However, the other 3 cases and 4 cases with mild intertrochanteric extension were treated conservatively without problem.
  
  
  CONCLUSIONS
  The evaluation of IFGT with MPR CT was shown to be valuable for determining the optimal treatment method.
authors.affiliation: Department of Orthopedic Surgery, Incheon St. Mary's Hospital, Incheon, Korea.
authors.forename: Juyoung
authors.initials: J
authors.lastname: Kim
authors.forename: Hyeong Jo
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Jeong Joon
authors.initials: JJ
authors.lastname: Yoo
authors.forename: Hee Joong
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007103:Immobilization; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome