Executive Editor: Amy Kapatkin General Editor: Noel Moens

Authors: Tomas Guerrero

Proximal Femur

back to skeleton

Glossary

Surgical procedures sorted by fracture type

Use this menu to jump directly into a specific classification (optional):
A1 A2 A3 B1 B2 B3 C1 C2 C3
A1

Trochanteric region, avulsion

Please select a treatment option:
Treatment Main indication Skill Equipment
Tension band Avulsion fracture of the greater trochanter, mainly in young patients. Also used to reconstruct trochanteric osteotomies. Basic surgical experience, no specialized skills Basic equipment only
A2

Trochanteric region, intertrochanteric simple

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate fixation Standard option of treatment for simple intertrochanteric fractures Some specialized surgical experience Full specialized surgical and imaging resources
A3

Trochanteric region, multifragmentary

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate fixation with lag screws and pins Multifragmentary with reducible or nonreducible fragments Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Tie-in technique Patients with not enough proximal bone stock to use plate fixation Some specialized surgical experience Simple surgical and imaging resources
Plate and rod Multifragmentary with nonreducible fragments Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B1

Simple basicervical

Please select a treatment option:
Treatment Main indication Skill Equipment
Parallel K-wires Basicervical fractures Highly experienced and skilled surgeon Basic equipment only
Lag screw and K-wire Standard option of treatment for basicervical fractures Highly experienced and skilled surgeon Simple surgical and imaging resources
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B2

Simple transcervical

Please select a treatment option:
Treatment Main indication Skill Equipment
Parallel K-wires Skeletally immature patients (SH type I capital physeal fractures) Some specialized surgical experience Basic equipment only
Lag screw and K-wire Transcervical fractures in skeletally mature patients Highly experienced and skilled surgeon Simple surgical and imaging resources
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and premature closure of the proximal femoral physis Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and premature closure of the proximal femoral physis Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B3

Simple cervical with trochanteric avulsion

Please select a treatment option:
Treatment Main indication Skill Equipment
Combined treatment options Cervical fractures or physeal fracture with trochanteric avulsion in young patients Some specialized surgical experience Basic equipment only
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and premature closure of the proximal femoral physis Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and premature closure of the proximal femoral physis Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C1

Capital, articular simple

Please select a treatment option:
Treatment Main indication Skill Equipment
Fragment removal Small fragments not amenable for fixation Basic surgical experience, no specialized skills Basic equipment only
Lag screw and K-wire Reducible fragments large enough for screw fixation Highly experienced and skilled surgeon Simple surgical and imaging resources
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and non reconstructible fractures Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and non reconstructible fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C2

Capital, articular multifragmentary

Please select a treatment option:
Treatment Main indication Skill Equipment
Fragment removal Small fragments not amenable for fixation Basic surgical experience, no specialized skills Basic equipment only
Lag screw and K-wire Reducible fragments large enough for screw fixation Highly experienced and skilled surgeon Simple surgical and imaging resources
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and non reconstructible fractures Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease, and non reconstructible fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C3

Multifragmentary cervical and trochanteric

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate and lag screw fixation Standard option of treatment for multifragmentary cervical and trochanteric fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Femoral head and neck ostectomy Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease Basic surgical experience, no specialized skills Basic equipment only
Nano or mini total hip replacement (THR) Failed primary fixation of fractures, non-treated fractures, severe degenerative joint disease Highly experienced and skilled surgeon Full specialized surgical and imaging resources
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2017-11-07