ĐÁNH GIÁ HÌNH THÁI VÀ PHÂN LOẠI GÃY LIÊN MẤU CHUYỂN XƯƠNG ĐÙI TRÊN CT-SCAN DỰNG HÌNH 3D TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Introduction: Intertrochanteric fractures are one of the most common types of hip fractures in the elderly. The classification of intertrochanteric fractures is a determining factor for an appropriate treatment strategy. This study aims to evaluate the morphology and number of intertrochanteric fracture fragments of the femur on 3D CT-scan reconstruction according to the Nakano-Shoda (2017) and Wada (2019) classifications. Methods and Materials: A cross-sectional descriptive study was conducted on 47 patients with intertrochanteric fractures who underwent 3D CT-scan from January 2021 to August 2022. Fracture patterns were analyzed using two new CT-based classification systems. Results: According to Nakano-Shoda classification, the most common fracture type was 3-fragment G-L pattern (53.2%), followed by ≥4-fragment pattern (19.2%). Unstable fractures accounted for 76.6% of cases. Based on Wada classification, 4-fragment GP/L was the most prevalent pattern (44.7%). The main mechanisms of instability were isolated posteromedial instability (46.8%) and combined posteromedial and lateral wall instability (21.3%). Several cases classified as stable fractures on X-rays were revealed to be unstable when evaluated with 3D CT-scan. Conclusion: 3D CT-scan enables accurate identification of unstable fractures. Wada classification helps analyze detailed mechanisms of instability, while Nakano-Shoda classification is more practical for clinical application. These findings support the value of 3D CT-scan and new classification systems in evaluating intertrochanteric fractures.