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The Evans–Jensen classification is a system of categorizing intertrochanteric hip fractures based on the fracture pattern of the proximal femur. Classification
A femoral fracture is a bone fracture that involves the femur. They are typically sustained in high-impact trauma, such as car crashes , due to the large amount of force needed to break the bone. Fractures of the diaphysis , or middle of the femur, are managed differently from those at the head, neck, and trochanter ; those are conventionally ...
A hip fracture is a break that occurs in the upper part of the femur (thigh bone), at the femoral neck or (rarely) the femoral head. [2] Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. [2] Usually the person cannot walk. [3] A hip fracture is usually a femoral neck fracture.
The distal capsular attachment on the femur follows the shape of the irregular rim between the head and the neck. As a consequence, the capsule of the hip joint attaches in the region of the intertrochanteric line on the anterior side, but a finger away from the intertrochanteric crest on the posterior side of the head. [4]
The intertrochanteric crest is a prominent smooth bony ridge upon the posterior surface of the femur at the junction of the neck and the shaft of the femur; [1] together with the intertrochanteric line on the anterior side of the head, the intertrochanteric crest marks the transition between the femoral neck and shaft. [2]: 192
An extracapsular fracture is a bone fracture near a joint but still located outside the joint capsule. [1] Examples of extracapsular fractures are intertrochanteric and subtrochanteric hip fractures. [citation needed]
Closed reduction is the manipulation of the bone fragments without surgical exposure of the fragments. See also: Closed reduction with internal fixation Open reduction is where the fracture fragments are exposed through surgical dissection of tissues.
For low-grade fractures (Garden types 1 and 2), standard treatment is fixation of the fracture in situ with screws or a sliding screw/plate device. In elderly patients with displaced or intracapsular fractures many surgeons prefer to undertake a hemiarthroplasty , replacing the broken part of the bone with a metal implant.