Three-Dimensional Computed Tomography (CT) Mapping of Intertrochanteric Fractures in Elderly Patients.

BACKGROUND The complex anatomy of the trochanter and the diversity in mechanisms of injury to it complicate intertrochanteric fracture patterns. Using digital technology, we created three-dimensional (3D) computed tomography (CT) mapping to show the relevant characteristics of intertrochanteric fractures in elderly patients. MATERIAL AND METHODS This was a retrospective analysis of a case series of closed intertrochanteric fractures in patients older than age 60 years who had sustained single-sided injuries less than 1 week previously. High-quality CT scans of the cases were used to create a 3D reconstruction fracture model, and fracture maps of the proximal femur were created by overlapping the fracture lines. RESULTS A total of 115 patients were enrolled in this study, with mean age of 78 years (SD 7.98 years; range, 60 to 96 years). The essential features of the fracture lines were recorded in each case. Fracture maps revealed that the fracture lines were mainly concentrated in the area of the lesser and greater trochanter, intertrochanteric line, and intertrochanteric crest. As for fracture subtypes, results between patients were similar for Types A1 and A2 fractures, and differed for Type A3 fractures. CONCLUSIONS Detailed analysis of essential features of fracture lines revealed fracture fragments, some of which may be difficult to see using traditional imaging methods. Fracture maps composed of interindividual fracture lines revealed the relevant characteristics of intertrochanteric fractures in elderly patients. The resulting information about characteristics of distribution of fracture lines may be helpful in clinical practice.