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Intertrochanteric Femoral Fractures

Classification

Kyle

Kyle Classification of Intertrochanteric Femoral Fractures
Type Stability Description
I Stable 2-part, no comminution
II 3-part, minimal comminution
III Unstable 4-part, large posteromedial comminuted area
IV subtrochanteric extension, highly unstable

Evan’s

  • Most useful
  • Two types depending on direction of major fracture line
  • Type 1 Extends superolaterally from LT
    • Undisplaced : stable
    • Displaced reduced : stable with medial cortex apposition
    • Displaced unreduced : unstable with no medial apposition
    • Comminuted : unstable with no medial apposition
  • Type 2 Extends inferolaterally from LT
    • Femoral shaft medially displaced by adductors : unstable
  • Timing (McNeill)
    • 10x ↑ in mortality if operation delayed >48 hrs