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<sec><h3>Background</h3><p>The AO Foundation/Orthopaedic Trauma Association (AO/OTA) introduced a new trochanteric fracture classification in January 2018, concerning the lateral wall integrity. It suggested the intramedullary nail fixation in patients with an incompetent lateral wall fracture.</p></sec>
<sec><h3>Objective</h3><p>To determine the reliability of lateral wall-thickness measurement and the fracture parameters associated with lateral wall integrity.</p></sec>
<sec><h3>Methods</h3><p>This retrospective study evaluated patients with an intertrochanteric fracture who had had surgery in King Chulalongkorn Memorial Hospital between January 2014 and January 2019. The lateral wall was measured by anteroposterior plain radiography by four raters, two times each. The demographic data and fracture parameters were assessed and compared with respect to lateral wall integrity.</p></sec>
<sec><h3>Result</h3><p>In a total of 236 femurs and 232 patients having the 2018 AO/OTA-specified 31A1 and 31A2 intertrochanteric fractures, the lateral wall-thickness measurement showed excellent inter-rater reliability at 0.944 (0.927–0.957) and good-to-excellent intra-rater reliability ranging from 0.835 to 0.972. The parameters associated with lateral wall incompetence as per the multivariate logistic regression analysis were fracture angle (odds ratio [OR] = 0.95), distal greater trochanter involvement (OR = 9.47), and fragments at the intertrochanter area (OR = 4.49) and at the lesser trochanter (OR = 2.6).</p></sec>
<sec><h3>Conclusion</h3><p>Some of the parameters related to trochanteric fractures are associated with lateral wall incompetence. Lateral wall-thickness measurement is a reproducible method, which has been suggested for use by the AO/OTA 2018 classification. It is easy to use and can help select the appropriate treatment for intertrochanteric fracture patients.</p></sec>
</abstract>

BackgroundThe AO Foundation/Orthopaedic Trauma Association (AO/OTA) introduced a new trochanteric fracture classification in January 2018, concerning the lateral wall integrity. It suggested the intramedullary nail fixation in patients with an incompetent lateral wall fracture.
ObjectiveTo determine the reliability of lateral wall-thickness measurement and the fracture parameters associated with lateral wall integrity.
MethodsThis retrospective study evaluated patients with an intertrochanteric fracture who had had surgery in King Chulalongkorn Memorial Hospital between January 2014 and January 2019. The lateral wall was measured by anteroposterior plain radiography by four raters, two times each. The demographic data and fracture parameters were assessed and compared with respect to lateral wall integrity.
ResultIn a total of 236 femurs and 232 patients having the 2018 AO/OTA-specified 31A1 and 31A2 intertrochanteric fractures, the lateral wall-thickness measurement showed excellent inter-rater reliability at 0.944 (0.927–0.957) and good-to-excellent intra-rater reliability ranging from 0.835 to 0.972. The parameters associated with lateral wall incompetence as per the multivariate logistic regression analysis were fracture angle (odds ratio [OR] = 0.95), distal greater trochanter involvement (OR = 9.47), and fragments at the intertrochanter area (OR = 4.49) and at the lesser trochanter (OR = 2.6).
ConclusionSome of the parameters related to trochanteric fractures are associated with lateral wall incompetence. Lateral wall-thickness measurement is a reproducible method, which has been suggested for use by the AO/OTA 2018 classification. It is easy to use and can help select the appropriate treatment for intertrochanteric fracture patients.

Reliability of lateral wall-thickness measurement in trochanteric fractures and parameters associated with lateral wall integrity

Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society

Department of Orthopaedics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society

Asian Biomedicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

BackgroundThe AO Foundation/Orthopaedic Trauma Association (AO/OTA) introduced a new trochanteric fracture classification in January 2018, concerning the...

Reliability of lateral wall-thickness measurement in trochanteric fractures and parameters associated with lateral wall integrity

Article Category: Brief Communication

Published Online: Mar 20, 2024

Page range: 24 - 29

DOI: https://doi.org/10.2478/abm-2024-0005

Keywords
AO/OTA classification, fracture parameter, hip fractures, lateral wall thickness, reliability

© 2024 Chindarat Ratanakornphan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Reliability of lateral wall-thickness measurement in trochanteric fractures and parameters associated with lateral wall integrity

Article Category: Brief Communication

Published Online: Mar 20, 2024

Page range: 24 - 29

DOI: https://doi.org/10.2478/abm-2024-0005

KeywordsAO/OTA classification, fracture parameter, hip fractures, lateral wall thickness, reliability

© 2024 Chindarat Ratanakornphan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
AO/OTA classification, fracture parameter, hip fractures, lateral wall thickness, reliability