Executive Editor: Joseph Schatzker, Peter Trafton
Authors: Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken, Michael Baumgaertner
Proximal femur
back to skeleton
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Trochanteric fracture, pertrochanteric, simple
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
MIO - Sliding hip screw
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Surgeon's preference; closed reduction possible |
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Nailing
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Surgeon's preference; unstable fracture; closed reduction possible |
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ORIF - Sliding hip screw
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Inability to achieve closed reduction |
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Trochanteric fracture, pertrochanteric, multifragmentary
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
MIO - Sliding hip screw
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Adequate reduction and bone contact |
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MIO - Sliding hip screw with plate
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Insufficient fracture stability with sliding hip screw alone |
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Nailing
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Surgeon's preference, fracture instability |
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Trochanteric fracture, intertrochanteric
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
Nailing
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Any intertrochanteric fracture |
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ORIF - Dynamic condylar screw
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Any intertrochanteric fracture |
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Femoral neck fracture, subcapital, undisplaced or impacted
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
Nonoperative treatment
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Patients unfit for surgery; severe soft-tissue problems |
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MIO - Cancellous screws
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All subcapital fractures; patients unable to protect their hip |
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Femoral neck fracture, transcervical or basicervical
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
MIO - Cancellous screws
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Pauwels type I-II fractures, good bone quality |
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MIO - Sliding hip screw
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Pauwels type II-III fractures, osteoporosis, comminution |
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ORIF - Cancellous screws
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Failure of closed reduction; Pauwels type I-II fractures, good bone quality |
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ORIF - Sliding hip screw
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Failure of closed reduction; Pauwels type II-III fractures, osteoporosis, comminution |
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Arthroplasty
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Surgeon or local preference; older patient or irreducible fracture |
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Femoral neck fracture, subcapital, displaced
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
MIO - Cancellous screws
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Pauwels type I-II fractures, good bone quality |
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MIO - Sliding hip screw
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Pauwels type II-III fractures, osteoporosis, comminution |
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ORIF - Cancellous screws
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Failure of closed reduction; Pauwels type I-II fractures, good bone quality |
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ORIF - Sliding hip screw
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Failure of closed reduction; Pauwels type II-III fractures, osteoporosis, comminution |
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Arthroplasty
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Surgeon or local preference; older patient or irreducible fracture |
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Femoral head fracture, split
Please select a treatment option:
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Treatment |
Main indication |
Skill |
Equipment |
ORIF - Small fragment screws
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Split fractures with more proximal “Pipkin II” or larger fragments |
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*Skill |
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Basic surgical experience, no specialized skills |
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Some specialized surgical experience |
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Highly experienced and skilled surgeon |
*Equipment |
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Basic equipment only |
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Simple surgical and imaging resources |
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Full specialized surgical and imaging resources |
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