AAOS classification of periprosthetic hip fracture

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Hip fracture

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview[1][2][3]

The "hip" joint is known as a ball-and-socket joint. It allows the femur bone to bend and rotate at the pelvis. Comparing to the injuries to the knee, ankle, and shoulder which are well documented, injuries to the hip, pelvis, and thigh get little attentions due to their lower prevalence. A hip fracture is a known as a fracture of the upper quarter of the femur bone while any other types of injuries to the socket, or acetabulum, itself is not considered a "hip fracture." Management of fractures to the socket is a completely different consideration. The hip fracture count as a serious problems associated with serious and life-threatening complications. Hip fractures most commonly occur due to the:

Fall to the side of the hip A direct blow to the side of the hip Other medical conditions such as osteoporosis, cancer, or stress injuries affecting the strength. During fracture the most common site of fracture are:

The head of the femur The neck of the femur Between or below the greater trochanter and the lesser trochanters


American Academy of Orthopedic Surgeons (AAOS) classification

Hip fractures are categorized as:

  • level I: proximal femur distally to the lower extent of the lesser trochanter
  • level II: 10 cm of femur distal to level I
  • level III: femur distal to level II
American Academy of Orthopedic Surgeons (AAOS) classification
Type I fractures proximal to the intertrochanteric line; usually occur during dislocation of the hip
Type II vertical or spiral fractures that do not extend past lower extent of the lesser trochanter
Type III vertical or spiral fractures that extend past lower extent of lesser trochanter, but not beyond level II; usually at the junction of middle and distal thirds of the femoral stem
Type IV fractures that traverse femoral stem in level III or lie within that area
  • type IV-A: spiral fractures around the tip of the stem
  • type IV-B: simple transverse or short oblique fractures


Type V severely comminuted fractures around the stem in level III
Type VI fractures distal to the tip of the stem in level III

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References

  1. Collin PG, D'Antoni AV, Loukas M, Oskouian RJ, Tubbs RS (January 2017). "Hip fractures in the elderly-: A Clinical Anatomy Review". Clin Anat. 30 (1): 89–97. doi:10.1002/ca.22779. PMID 27576301.
  2. Rocos B, Whitehouse MR, Kelly MB (May 2017). "Resuscitation in hip fractures: a systematic review". BMJ Open. 7 (4): e015906. doi:10.1136/bmjopen-2017-015906. PMC 5623376. PMID 28473523.
  3. Bhandari M, Swiontkowski M (November 2017). "Management of Acute Hip Fracture". N. Engl. J. Med. 377 (21): 2053–2062. doi:10.1056/NEJMcp1611090. PMID 29166235.

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