RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Small, displaced, varus, tilted backwards 90º. Small medial spike nested into the shaft.. Comminution of the upper part of the femoral neck
Blue:
No. Lesser is attached to shaft
Green:
large comminuted fragment including the whole posterior wall
Lateral wall: competent
IM nail entry point: Comminuted
Cerclage possible ? No
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
small, displaced, tilted backwards 90º. Small medial spike anterior to the shaft. Comminution of the upper part of the femoral neck
Lateral part of femoral neck attached to shaft
Blue fragment:
No. Lesser is attached to shaft
Green:
No. Greater attached to shaft.
Lateral wall: Intact
IM nail entry point: intact
Additional fragment: anterior bone splinter (purple)
Cerclage possible ? No
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Large, displaced, varus. Includes greater and lateral wall.
Tilted backwards 45º. Anterior notch for shaft spike.
Blue:
Large, includes most of the posterior wall
Green:
NO
Lateral wall: Incompetent
IM entry point: Intact
Shaft: anterior spike
Cerclage possible ? Si
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Grossly displaced. Anterior shift. Tilted backwards 60º.
Large medial spike
Blue:
very small, bone flake, most of lesser attached to shaft
Green:
very small and comminuted, just the upper edge of greater.
Lateral wall: Intact
IM entry point: comminuted
Cerclage possible ? Si
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Grossly displaced. Tilted backwards.
Large anterior spike displaced anteriorly.
Blue:
Small anterior edge, rest of lesser attached to shaft.
Obstacle to reduction ?
Green:
Large, includes the whole lateral wall
Lateral wall: Incompetent. Included into green
IM entry point: Comminuted
Additional fragment: posterior edge of intertrochanteric line (orange)
Cerclage possible ? Si
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Large, almost non displaced, small medial spike.
Blue:
No, Included into green
Green:
Large, most of lesser, the whole posterior wall and the whole greater.
Lateral wall: Incompetent
IM entry point: comminuted
Cerclage possible ? No
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
displaced varus. tilted backwards 45º. Small medial spike
Blue:
NO. Part included into green, the anterior part attached to shaft.
Green:
Large, includes 3/4 of greater, most of posterior wall,
and the posterior half of lesser.
Lateral wall: Incompetent
IM entry point: comminuted
Additional fragment: posterior edge of intertrochanteric line (orange)
Cerclage possible ? No
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Small, Displaced varus 90º, small medial spike nested into the shaft.
No backwards tilt
Blue:
Large, tilted 45o, long spike extends down to the shaft
Green:
Large, displaced, includes 3/4 of greater, (only anterior edge of greater remains attached to shaft.)
Lateral wall: Competent/incompetent?
IM entry point: comminuted
Cerclage possible ? ???
RED FRAGMENT
BLUE FRAGMENT
GREEN FRAGMENT
LATERAL WALL
IM NAIL ENTRY POINT
CERCLAGE POSSIBLE ?
Red Fragment:
Grossly displaced. Tilted backwards 45º Large postero medial spike.
Blue:
NO. lesser attached to the shaft
Green:
Large, displaced, includes the whole greater and upper part
of the femoral neck
Lateral wall: incompetent
IM entry point: comminuted
Cerclage possible ? No
2 / 3 / 4 PARTS
GREATER / POSTERIOR (ORANGE)
LESSER / ANTERIOR (BLUE) - IMPINGEMENT
SPLIT HEAD / JOINT SURFACE
DISPLACEMENT / STEP OFF / HEAD SHIFT-TILT (RED)
AVN RISK
Red Fragment:
Displaced distally. Very large postero-medial spike
Blue:
Very large. Includes the whole lesser, most of posterior wall, and a very large spike extend distally to the shaft.
Green:
NO. Included in the shaft.
Lateral wall: incompetent
IM entry point: comminuted
Cerclage possible ? Si