CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(04): 361-367
DOI: 10.1055/s-0039-1693045
Artigo de Revisão | Review Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Does Computed Tomography Improve Reproducibility in the Classification of Transtrochanteric Fractures?[]

Article in several languages: português | English
Murilo Alexandre
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
,
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
2  Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Edio Cavassani Neto
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
,
Nayra Deise dos Anjos Rabelo
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
,
Marcelo Cavalheiro de Queiroz
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
2  Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Walter Ricioli Junior
1  Grupo de Quadril, Departamento de ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Irmandade Santa Casa de Misericórdia, São Paulo, SP, Brasil
2  Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
› Author Affiliations
Further Information

Publication History

06 March 2018

30 October 2018

Publication Date:
20 August 2019 (online)

Abstract

With the aging of the population, there was a significant increase in the prevalence of hip fractures, with high mortality rates, sequelae and expenses. Understanding the fracture profile and classifying it correctly is critical to define the appropriate treatment. Several radiographic classifications have been developed for transtrochanteric fractures, such as Tronzo, Evans-Jensen, AO and Boyd-Griffin, but their reproducibility is not always satisfactory. The present review aimed to elucidate whether the addition of computed tomography (CT) implies a greater reproducibility than simple radiography in the classification of transtrochanteric fractures, and whether this is a better examination to identify the fracture trait. A search was conducted in the PubMed, Lilacs, Scielo and Cochrane databases between July 2016 and June 2017, limited to the last 15 years. All retrospective, prospective and systematic reviews articles published in the English language, with evaluation of men and/or women, were considered for review. We have excluded case reports, studies that evaluated tomography or radiographs in isolation, and duplicate studies. The research presented 112 articles, of which 5 contemplated the proposed criteria. Reproducibility for the classification of transtrochanteric fractures presented variable results and was influenced by factors such as the type of classification, the use of the simplified or complete classification, the specialty of the evaluator, his experience, and the methodology proposed by the works. There are indications that there is benefit for the use of CT, especially for fractures considered unstable, but its use as a tool to ensure better reproducibility (intra- and interobserver) remains controversial and needs further studies.

Work performed at the Hip Group, Orthopedics and Traumatology Department, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.