Evidence map›Paper›PMID 42332778›Full record

ArticleJournal of orthopaedic surgery and research2026

A novel classification system based on the lateral view of 3D-CT for predicting the reducibility of intertrochanteric fractures: a retrospective study.

Shiyun Qian, Yong Zhu, Kaihu Li, Zhangyuan Lin, Haitao Long, Ruibo Zhao, Buhua Sun, Shushan Zhao, Liang Cheng

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Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Shiyun QianDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Yong ZhuDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Kaihu LiDepartment of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410000, China.
Zhangyuan LinDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Haitao LongDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Ruibo ZhaoDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Buhua SunDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Shushan ZhaoDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Liang ChengDepartment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China. doccheng@csu.edu.cn.

Funding

the Natural Science Foundation of Hunan Province No.2021JJ30038
6 · The paper itself

Abstract

objectiveCurrent classifications for intertrochanteric fractures poorly predict the difficulty of achieving closed reduction. This study aimed to develop and validate a novel classification system based on the lateral view of three-dimensional computed tomography (3D-CT) to preoperatively assess reducibility.

methodsWe retrospectively reviewed 609 patients with intertrochanteric fractures. After screening, 318 cases (117 AO/OTA 31-A1 and 201 AO/OTA 31-A2) were included. Based on preoperative 3D-CT, fracture morphology was categorized as flexed, neutral, or extended types. The intraoperative outcome of closed reduction was used to define fractures as reducible or irreducible.

resultsAmong the 318 fractures, 174 (54.7%) were reducible and 144 (45.3%) were irreducible. The reducible group included 105 flexed, 21 neutral, and 48 extended types. The irreducible group comprised 90 flexed-type and 54 extended-type fractures. Irreducible flexed-type and extended-type fractures were further subdivided into 3 distinct subtypes each, based on characteristic radiological features.

conclusionThe proposed classification system, which integrates the AO/OTA framework with 3D-CT morphology, effectively identifies fractures at high risk for irreducible closed reduction. This system can help surgeons avoid futile reduction attempts and guide the choice of an appropriate reduction strategy.

Indexed as

Hip FracturesImaging, Three-DimensionalProximal Femoral FracturesTomography, X-Ray ComputedAgedAged, 80 and overFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesClassificationClosed reductionIntertrochanteric fractureIrreducible fractureThree-dimensional computed tomography

Identifiers

PMID42332778
PMCPMC13540828

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