![]() ![]() The neck of femur fractures are highly prevalent injuries, with approximately 1.6 million cases reported per annum. International Journal of the Care of the Injured We analysed functional outcomes based on radiographic evidence and/or the resolution of symptoms and/or complication rates documented during the follow-up period. ![]() Furthermore, each subset was classified according to the specific treatment applied. The primary outcome measure included the type of treatment method utilised to manage IGTF categorized into two subgroups, surgical vs. A meta-analysis could not be performed due to the heterogeneity of the reports. Microsoft Excel version 2016 (Windows) was used for analysis. Articles that were included in the study were assessed using Sackett's Level of Evidence. It included: year of publication, first author, study design, number of included patients, imaging modality used for diagnoses, mean age, method of management of IGTF, and average follow-up period. A predefined checklist was used to input data using the Microsoft Excel database. No grey literature was included in this study.ĭata extraction was performed independently by 2 authors (AS, RB). We also identified relevant studies by a backward and forward citation search within included studies. Information sources, Literature search, study identification, and search strategy:Ī systematic literature review of the PubMed, Central Register of Controlled Trials (Cochrane), EMBASE, and CINAHL databases by using the search term ‘greater trochanter fracture and hip fracture’ was undertaken and included all relevant studies from inception until January 2021. Inclusion Criteria: The inclusion criteria consisted of articles describing treatment protocols of IGTF, confirmed on Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), published in the English language, prospective and retrospective non-experimental studies, Randomised Control Trials (RCT's) and observational studies.Įxclusion Criteria: We excluded studies describing the management of IGTF in patients diagnosed using X-RAY imaging (plain radiographs) only, studies where no comment was made on the treatment of IGTF, not written in English, full-text unavailability, letters, and meeting proceedings. We identified studies that met the following criteria: This systematic review focuses on managing IGTF, providing treatment recommendations with a pooled analysis of the most up-to-date available literature. Due to the lack of an evidence-based classification of these injuries, and indications for surgical management, consensus on treatment selection has yet to be established. Several treatment options are recommended for managing IGTF. Often, many of these fractures extend beyond the intertrochanteric line, complicating the approach and management to such cases. 7 When initial plain radiographs show an IGTF, the vast majority of studies strongly recommended further imaging analyses (with the use of Magnetic resonance imaging or Computed tomography). ![]() The pain may be mild or even an asymptomatic incidental radiological finding. However, the diagnoses of IGTF can be quite challenging, as they may clinically present similar to that of any other hip fracture, with an occult radiological presentation. The diagnoses of any proximal femoral fractures are based on the appropriate clinical history and physical examination and further confirmed by radiological imaging. Avulsion injuries are observed more commonly in children or younger adolescents, whereas traumatic injuries (following a direct blow or fall) are encountered more often in the elderly population. 1, 2, 3, 4, 5 There is a widespread debate about the aetiology and exact patho-mechanism of IGTF with an epidemiological variance. Isolated greater trochanteric fractures (IGTF) are uncommon subtypes of hip fractures, with scarcity of orthopaedic reports in the literature and limited textbook coverage on their demographics and management protocols.
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