title: Fracture morphology of AO/OTA 31-A trochanteric fractures: A 3D CT study with an emphasis on coronal fragments.
abstract: OBJECTIVE
  This study was designed to assess the incidence and morphology of coronal plane fragments in AO/OTA 31-A trochanteric fractures.
  
  
  METHODS
  156 cases of AO/OTA 31-A trochanteric fractures were retrospectively evaluated. Lateral radiographs were analyzed for the presence of coronal plane fragments followed by analysis of 3D CT reconstructions in these fractures. The incidence of coronal fragments identified on the lateral radiograph and 3D CT reconstructions were both calculated. Coronal fragment morphology was described based upon the origin and exit points of fracture lines and the number of fragments.
  
  
  CONCLUSIONS
  On plain radiographs, a coronal plane fracture was identified in 59 cases, an incidence of 37.8% (59/156). In comparison, 3D CT reconstructions identified coronal plane fractures in 138 cases for an incidence of 88.4% (138/156). 3D CT reconstructions identified coronal fracture fragments in 81.9% (50/61) of AO/OTA 31-A1 cases, 94.5% (69/73) of 31-A2 cases, and 86.3% (19/22) of 31-A3 cases. Incidence of coronal fractures identified on plain radiographs of 3 AO/OTA 31-A1,A2,A3 groups was lower when compared to the incidence of coronal fractures identified on 3D CT. Of the 138 cases that had coronal plane fracture, 82 cases (59.4%) had a single coronal fragment (GT fragment 35 cases, GLT fragment 19 cases, GLPC fragment 28 cases). The remaining 56 cases (40.5%) had two coronal fragments. There is a high incidence of coronal fragments in intertrochanteric femur fractures when analyzed with 3D CT reconstructions. Our study suggests that these coronal fragments are difficult to identify on plain radiographs. Knowledge of the incidence and morphology of coronal fragments helps to avoid potential intraoperative pitfalls.
authors.affiliation: Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address: jeus1103@gmail.com.
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, UC Davis Medical Center, Sacramento, CA, USA. Electronic address: kentbt@gmail.com.
authors.forename: William T
authors.initials: WT
authors.lastname: Kent
authors.affiliation: Department of Orthopedic Surgery, Gacheon University Gil Hospital Trauma Center, Republic of Korea. Electronic address: dryoonyc@gmail.com.
authors.forename: Yong-Cheol
authors.initials: YC
authors.lastname: Yoon
authors.affiliation: Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Republic of Korea. Electronic address: medic-young@hanmail.net.
authors.forename: Youngwoo
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address: hyunkhim37@naver.com.
authors.forename: Hyungon
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address: ashu802005@yahoo.co.in.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Jha
authors.affiliation: Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address: senthilhit99@gmail.com.
authors.forename: Senthil Kumar
authors.initials: SK
authors.lastname: Durai
authors.affiliation: Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address: jkoh@korea.ac.kr.
authors.forename: Jong-Keon
authors.initials: JK
authors.lastname: Oh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: 3D CT; Coronal fragment; Fracture morphology; Intertrochanteric fracture