Anteromedial cortical support reduction of intertrochanteric fractures–A review

• Published in: Injury Vol. 55; no. 12; p. 111926
• Main Authors: Xie, Wenjun, Shi, Liu, Zhang, Cheng, Cui, Xueliang, Chen, Xiangxu, Xie, Tian, Zhang, Sheng, Chen, Hui, Rui, Yunfeng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2024
• Subjects: Anteromedial cortical reduction; Fracture reduction; Intertrochanteric fracture; Negative support; Neutral; Positive support; Fracture reduction; Neutral; Anteromedial cortical reduction; Intertrochanteric fracture; Positive support; Negative support
• ISSN: 0020-1383; 1879-0267; 1879-0267
• DOI: 10.1016/j.injury.2024.111926

•This study collated relevant studies and explained the anatomical basis, causes and latest progress of the loss of anteromedial cortical support in intertrochanteric fractures.•This study highlighted that positive and neutral support in the anteromedial cortex are more crucial than negative support. It also examined the relative importance of positive support versus neutral support and the significance of the anterior cortex compared to the medial cortex.•Based on the anteromedial cortex theory of intertrochanteric fractures, the easily confused concepts are described. The intertrochanteric fracture is a common fragility fracture typically resulting from low-energy falls. The functional outcome of intertrochanteric fractures is closely linked to the patient's underlying physical condition, intraoperative procedures, and postoperative complications. In terms of surgery, while timely surgery and appropriate internal fixation have demonstrated favorable outcomes, attention to intraoperative reduction is crucial. In recent years, there have been further developments in the evaluation of reduction of intertrochanteric fractures, particularly in the anteromedial cortical reduction, and these advances have been further scientifically elucidated in terms of their ability to provide stable fracture reduction and resist loss of reduction. In order to gain a comprehensive understanding of the anteromedial cortex theory, this article reviewed the anatomy, related theoretical progress, and controversies in recent years.