Classifications in Brief: The Russell-Taylor Classification of Subtrochanteric Hip Fracture

Abstract

Subtrochanteric fractures occur in the proximal region of the femur. Anatomically speaking, the subtrochanteric region of the femur is defined as the interval between the lesser trochanter and approximately 5 cm below it, toward the isthmus of the femur [1,13]. Subtrochanteric fractures are relatively common, accounting for approximately 10% to 30% of all hip fractures [4,16]. The subtrochanteric region is subject to tensile and compressive stressors that are substantially greater than the patient's body weight [11] as well as rotational and bending forces that directly influence the observed fracture patterns. These fractures commonly have short proximal fragments of comminution, which are pulled into flexion by the forces of the iliopsoas attaching on the lesser trochanter [9,10]. Additionally, the comminution can be deformed into an abducted and externally rotated position as a result of the pull on the greater trochanter by the abductor muscles. This proximal Each author certifies that neither he, nor any member of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institution approved the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.

From Koch’s Bone Biomechanical Analysis to Contemporary Proximal Femur Fracture Management

“…Moreover, no classification seems to guide surgical treatment choices apart from comminuted fractures or those that extend into the trochanteric region. These fractures lead to a higher fixation failure rate, and thus screw-plate or IMN fixation can be used for stable fractures, and IMN for unstable fractures [23,25,26]. Over time, with the improvement of IMN implants and reduction techniques, the clinical utility of classifications has decreased [26].…”

Functional Outcome of Proximal Femoral Nail Antirotation (Pfna) in Proximal Femur Fracture

“…The evolving treatment landscape, highlighted by the transition towards more individualized care and the consideration of patientspecific characteristics, demands a high level of expertise and adaptability from orthopedic surgeons. The adoption of the Russell-Taylor classification system for subtrochanteric fractures exemplifies this trend, providing a framework that informs surgical planning and implant selection (17). The management of atypical fractures, particularly those associated with long-term bisphosphonate therapy, further illustrates the complexity of treatment strategies, necessitating vigilant monitoring and, in some cases, prophylactic fixation to prevent complication progression (18).…”

Subtrochanteric femoral fractures: A case series of 194 patients treated with long and short intramedullary nails

“…The Russell-Taylor classification is based on involvement of the lesser trochanter and fracture extension up to the piriformis fossa and is primarily used in our study. 4 Operative management of subtrochanteric fractures is the main treatment. Intramedullary nails (IM) and extramedullary plates are the first surgical implant options.…”