Is magnetic resonance imaging necessary in isolated greater trochanter fracture? A systemic review and pooled analysis

BMC Musculoskeletal Disorders

Research Article

Joonghyun Ahn¹  Seung-Ju Kim¹  Hyung Kook Kim¹  Jong Hun Kim² 

[1] Department of Orthopedics, KEPCO Medical Foundation, KEPCO Medical center, 308 Uicheon-ro, Dobong-Gu, 132-703, Seoul, Korea;Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 136-705, Seoul, Korea;

关键词: Greater trochanter;    Fracture;    MRI;   

DOI  :  10.1186/s12891-015-0857-y

 received in 2015-07-22, accepted in 2015-12-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIsolated fractures of the greater trochanter (GT) of the femur are uncommon and few studies have assessed the diagnosis and appropriate therapeutic schedule for these fractures. The current data regarding assessment of isolated fractures of the GT are limited to a few reviews based on the experience of a single institution. Therefore, we asked the following questions: (1) what proportion of cases has an associated extension of the fracture into the intertrochanteric region in isolated GT fracture and (2) what are the treatment options and outcomes of GT fractures with occult intertrochanteric fractures.MethodsWe conducted a systematic review of published studies that evaluated patients who displayed isolated GT fracture on routine radiographic examination and underwent a magnetic resonance imaging (MRI) scan because of the suspicion of extension into the intertrochanteric region. A structured literature review of multiple databases (PubMed, EMBASE, CINAHL, and Cochrane systematic reviews) referenced articles from 1950 to 2015.ResultsA total of 110 patients were identified from 7 published studies. MRI documented isolated GT fractures diagnosed on initial radiographs in only 11 of 110 patients (10 %). In 99 patients (90 %), MRI examinations revealed extension of the fracture into the intertrochanteric region. Surgical fixation was necessary for 61 patients, with a pooled percentage of 55 %. No complications were observed after surgery.ConclusionsOur study has helped to elucidate further the assessment of isolated fracture of the GT. We believe that MRI is a reasonable option for patients presenting with isolated GT fracture on plain radiographs.

【 授权许可】

CC BY   
© Kim et al. 2015