Incomplete intertrochanteric fractures: Imaging features and clinical management

PURPOSE: To present the imaging findings and treatment options for incomple te intertrochanteric fractures. MATERIALS AND METHODS: Among 31 patients with the magnetic resonance (MR) i maging diagnosis of incomplete intertrochanteric fracture, 30 also underwen t radiography. MR and radiographic findings were compared. Note was made of fracture length and extent as depicted on the coronal and axial MR images, treatment (surgical vs conservative), and follow-up. RESULTS: Correlation between radiographic and MR findings was poor. Incompl ete intertrochanteric fracture was the prospective radiographic diagnosis i n only one case. Fracture in 18 patients was treated surgically and in 13 w as managed conservatively. In both groups, the average age of the patients and length of the fractures and the percentage of separate fractures involv ing the greater trochanter and crossing the midline of the femur in the axi al plane were the same. Fractures crossed the midline in the coronal plane in 50% of the surgical group but in only 23% of the nonsurgical group. Aver age time from injury to ambulation was 2 days less in the surgical group, b ut no difference in functional status was found subjectively between the tw o groups at clinical follow-up. CONCLUSION: Incomplete intertrochanteric fractures are a previously unrecog nized subset of intertrochanteric fractures that are diagnosed unequivocall y only with MR-imaging.