--- title: "Trochanteric fx and anterior approach with fx table. | Sutter Health" description: "Worse preop ambulatory status, dx of slipped capital femoral epiphysis or rheumatoid arthritis, greater DORR ratio, lower FNCR were assoc with increased fx risk" url: "https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Trochanteric fx and anterior approach with fx table. # Isolated greater trochanteric fracture and the direct anterior approach using a fracture table. Hartford JM, Graw BP, Knowles SB, & Frosch DL. _J Arthroplasty. pii: S0883-5403(18)30199-2. doi: 10.1016/j.arth.2018.02.051. \[Epub ahead of print\]_ 2018-02-21 ## Abstract BACKGROUND: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach. METHODS: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Radiographs were evaluated for femoral neck angle, femoral neck cut ratio (FNCR), and DORR ratio. Bivariate and logistic regression analyses were performed. RESULTS: Thirty-one hips sustained isolated greater trochanter fractures (2.2%). Multivariate analyses identified worse preoperative ambulatory status, diagnosis of slipped capital femoral epiphysis or rheumatoid arthritis, lower FNCR and greater DORR ratio as statistically significant predictors for fracture. Four intraoperative fractures underwent fixation. All postoperative fractures were treated nonoperatively. Thirty fractures healed with 1 nonunion. CONCLUSION: Worse preoperative ambulatory status, diagnosis of slipped capital femoral epiphysis or rheumatoid arthritis, greater DORR ratio, and lower FNCR were associated with increased risk of fracture. Hips with fractures had longer length of stay. Nonoperative treatment was uniformly successful. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29555500) ## Research topics - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [High revision and reoperation rates using the Agility™ Total Ankle System.](https://www.sutterhealth.org/research/publications/high-rev-reop-rates-agility-total-ankle-syst-1055312437) Criswell BJ, Douglas K, Naik R, Thomson AB. Clin Orthop Relat Res. 470(7):1980-6. doi: 10.1007/s11999-012-2242-6. Epub 2012 Jan 24. 2012 Jul 01 - Publication ### [DPM foot and ankle fellowships.](https://www.sutterhealth.org/research/publications/dpm-foot-and-ankle-fellowships-1055312316) McAlister JE, Hyer CF, Miller JM, Rush S, Saxena A, Steinberg JS, Weil L Jr. Foot Ankle Spec. 6(5):356-63. doi: 10.1177/1938640013500767. 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J Foot Ankle Surg. 56(5):916. doi: 10.1053/j.jfas.2017.06.012. 2017 Sep 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Trochanteric fx and anterior approach with fx table."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306#medicalscholarlyarticle","name":"Isolated greater trochanteric fracture and the direct anterior approach using a fracture table.","headline":"Trochanteric fx and anterior approach with fx table.","abstract":"BACKGROUND: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach. METHODS: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Radiographs were evaluated for femoral neck angle, femoral neck cut ratio (FNCR), and DORR ratio. Bivariate and logistic regression analyses were performed. RESULTS: Thirty-one hips sustained isolated greater trochanter fractures (2.2%). Multivariate analyses identified worse preoperative ambulatory status, diagnosis of slipped capital femoral epiphysis or rheumatoid arthritis, lower FNCR and greater DORR ratio as statistically significant predictors for fracture. Four intraoperative fractures underwent fixation. All postoperative fractures were treated nonoperatively. Thirty fractures healed with 1 nonunion. CONCLUSION: Worse preoperative ambulatory status, diagnosis of slipped capital femoral epiphysis or rheumatoid arthritis, greater DORR ratio, and lower FNCR were associated with increased risk of fracture. Hips with fractures had longer length of stay. Nonoperative treatment was uniformly successful.","description":"Worse preop ambulatory status, dx of slipped capital femoral epiphysis or rheumatoid arthritis, greater DORR ratio, lower FNCR were assoc with increased fx risk","keywords":["Musculoskeletal Disorders"],"datePublished":"2018-02-21","url":"https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"29555500"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1016/j.arth.2018.02.051"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/29555500/","https://doi.org/10.1016/j.arth.2018.02.051"],"isPartOf":{"@type":"Periodical","name":"J Arthroplasty"},"author":[{"@type":"Person","name":"Hartford JM"},{"@type":"Person","name":"Graw BP"},{"@type":"Person","name":"Knowles SB"},{"@type":"Person","name":"Frosch DL"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Musculoskeletal Disorders","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Musculoskeletal+Disorders%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/trochanteric-fx-and-anterior-approach-with-fx-table-1055312306#breadcrumblist"}}} ```