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Musculoskeletal
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Trauma
Hip and Pelvis
Bones and Joints
Hip and Proximal Femur
Subtrochanteric and Femoral Shaft Fracture
Subtrochanteric and Femoral Shaft Fracture
MK Jesse, MD
;
Julia R. Crim, MD
;
Adam C. Zoga, MD
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Proximal femoral shaft fracture
Definitions
Subtrochanteric fracture: ≤ 5 cm below lesser trochanter
Femoral shaft fracture: > 5 cm distal to lesser trochanter
Segmental fracture: shaft fractured in 2 locations, isolating segment of bone between 2 fracture lines
Intercalated segment: portion of bone isolated between 2 fracture lines in segmental fracture
Intercalated segment often has impaired vascularity
Bisphosphonate fracture: fracture related to failure of bone remodeling in patients on long-term bisphosphonate therapy
Also designated atypical femur fracture
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Marshall RA et al: Imaging features and management of stress, atypical, and pathologic fractures. Radiographics. 38(7):2173-92, 2018
Hak DJ et al: Ipsilateral femoral neck and shaft fractures: current diagnostic and treatment strategies. Orthopedics. 38(4):247-51, 2015
Probyn L et al: Bilateral atypical femoral fractures: how much symmetry is there on imaging? Skeletal Radiol. 44(11):1579-84, 2015
Ekström W et al: Quality of life after a subtrochanteric fracture: a prospective cohort study on 87 elderly patients. Injury. 40(4):371-6, 2009
Goh SK et al: Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br. 89(3):349-53, 2007
Kregor PJ et al: Unstable pertrochanteric femoral fractures. J Orthop Trauma. 19(1):63-6, 2005
Haidukewych GJ et al: Nonunion of fractures of the subtrochanteric region of the femur. Clin Orthop Relat Res. (419):185-8, 2004
Tornetta P 3rd: Subtrochanteric femur fracture. J Orthop Trauma. 16(4):280-3, 2002
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Proximal femoral shaft fracture
Definitions
Subtrochanteric fracture: ≤ 5 cm below lesser trochanter
Femoral shaft fracture: > 5 cm distal to lesser trochanter
Segmental fracture: shaft fractured in 2 locations, isolating segment of bone between 2 fracture lines
Intercalated segment: portion of bone isolated between 2 fracture lines in segmental fracture
Intercalated segment often has impaired vascularity
Bisphosphonate fracture: fracture related to failure of bone remodeling in patients on long-term bisphosphonate therapy
Also designated atypical femur fracture
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Marshall RA et al: Imaging features and management of stress, atypical, and pathologic fractures. Radiographics. 38(7):2173-92, 2018
Hak DJ et al: Ipsilateral femoral neck and shaft fractures: current diagnostic and treatment strategies. Orthopedics. 38(4):247-51, 2015
Probyn L et al: Bilateral atypical femoral fractures: how much symmetry is there on imaging? Skeletal Radiol. 44(11):1579-84, 2015
Ekström W et al: Quality of life after a subtrochanteric fracture: a prospective cohort study on 87 elderly patients. Injury. 40(4):371-6, 2009
Goh SK et al: Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg Br. 89(3):349-53, 2007
Kregor PJ et al: Unstable pertrochanteric femoral fractures. J Orthop Trauma. 19(1):63-6, 2005
Haidukewych GJ et al: Nonunion of fractures of the subtrochanteric region of the femur. Clin Orthop Relat Res. (419):185-8, 2004
Tornetta P 3rd: Subtrochanteric femur fracture. J Orthop Trauma. 16(4):280-3, 2002
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