[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-457540-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-457540-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","the-double-intra-pertrochanteric-femur-fracture-an-irreducible-and-redisplaceable-fracture-pattern","The “double-intra” pertrochanteric femur fracture: an irreducible and redisplaceable fracture pattern","","Irreducible pertrochanteric femur fractures (PFFs) carry mechanical instability and poorer clinical results. This study introduces “double-intra” PFFs, defined by intramedullary head–neck varus impaction and an anterior fracture line located intracapsularly. Patients treated with a cephalomedullary nail (Jan 2021–Jun 2024) were managed with initial closed reduction using Chang reduction quality criteria, proceeding to limited open reduction with K-wire assistance when needed. Outcomes focus on reduction loss on fluoroscopy and postoperative 3D-CT, plus radiographic and functional follow-up.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-double-intra-pertrochanteric-femur-fracture-an-irreducible-and-redisplaceable-fracture-pattern/457540/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-double-intra-pertrochanteric-femur-fracture-an-irreducible-and-redisplaceable-fracture-pattern/457540.png","ImageObject",300,407,{"name":42,"@type":43},"Bulrr","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-10","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What defines the “double-intra” pertrochanteric femur fracture pattern?","Question",{"text":63,"@type":64},"It features intramedullary head–neck varus impaction and an anterior fracture line located intracapsularly, creating a distinct subtype of irreducible PFF.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were fractures treated when closed reduction was insufficient?",{"text":68,"@type":64},"Closed reduction was attempted first and judged with Chang reduction quality criteria targeting “excellent” anteromedial cortical support. If this standard was not met, a limited open reduction technique using bone hooks and 2.5 mm K-wires was performed.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the main findings about anteromedial cortical support loss and follow-up outcomes?",{"text":72,"@type":64},"A 46.4% reduction loss rate occurred intraoperatively after fixation, with further AMCS loss on postoperative radiographs. At 3 months, the AMCS group showed lower ΔNSA, shorter implant sliding distance, and higher postoperative PPM scores than the non-AMCS group.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},457540,1790794516,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Li etal. Journal of Orthopaedic Surgery and Research (2026) 21:18  \n[https://doi.org/10.1186/s13018-025-06545-x](https://doi.org/10.1186/s13018-025-06545-x)  \nJournal of Orthopaedic Surgery and Research  \nRESEARCH Open Access  \nThe “double-intra” pertrochanteric femur fracture: an irreducible and redisplaceable fracture pattern  \nHao-Tao Li 1, Shi-Min Chang 1*, Sun-Jun Hu 1, Shou-Chao Du 1, Wen-Feng Xiong 1 andYi-Ming Qi 1  \nAbstract  \nBackground Irreducible pertrochanteric femur fractures (PFFs) are associated with a higher risk of mechanical instability and poor clinical outcomes. Awareness of the specific patterns of these irreducible PFFs can help surgeons better prepare for fracture reduction and reduce unnecessary attempts at closed manipulations. This article aimed to introduce a specific subtype of irreducible PFFs, characterized by intramedullary head–neck varus impaction and the anterior fracture line located intracapsularly, termed “double-intra” PFFs.  \nMethods Patients with “double-intra” PFFs treated with cephalomedullary nail between January 2021 and June 2024 were included. Closed reduction was attempted initially, with fracture reduction quality assessed via Chang reduction quality criteria; the goal was to achieve “excellent” reduction, defined as anteromedial cortical support (AMCS) . If closed reduction failed to meet this standard, a limited open reduction technique (LORT) was used. Bone hooks and 2.5 mm Kirschner wires (K-wires) were used in the LORT to improve the reduction quality. Clinical and radiographic outcomes were utilized to summarize the fracture characteristics and loss of AMCS. The primary goal was assessing the fracture reduction loss in intraoperative fluoroscopies and postoperative 3D-CT images, and the secondary goal was determining the radiographic changes and functional outcomes in the follow-up.  \nResults Twenty-eight patients were retrospectively analyzed. All patients achieved “excellent” reduction before nail insertion; after fixation, 10 patients decreased to “acceptable” and 3 to “poor”, leading to a 46.4% reduction loss rate (13/28) during operation. Postoperative radiographs showed further AMCS loss in 7/15 patients (46 . 7%), and overall AMCS achievement rate on postoperative 3D-CT was 28 . 6%(8/28) . Additionally, at 3-month follow-up, the AMCS group had significantly lower ΔNSA (2 .25 ± 1.04 vs. 4.65 ± 1. 79, P = 0 . 002), implant sliding distance (3 .75 ± 1.16 vs.  \n6.65 ± 3. 00, P = 0 . 014), and higher postoperative PPM scores (7 .50 ± 1.07 vs. 6.35 ± 1. 04, P = 0 . 018) than the non-AMCS group.  \nConclusion The “double-intra” pattern is a specific irreducible PFF with difficulty in reduction and proneness toredisplacement perioperatively and postoperatively. Achieving a “double-positive” alignment of the anteromedial cortex and using temporary K-wire fixation as a routine procedure before nailing is essential to prevent reduction loss and improve the likelihood of maintaining the AMCS.  \n*Correspondence:  \nShi-Min Chang [shiminchang11@aliyun.com](shiminchang11@aliyun.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutor","cbCailUF7D7a2zmW","https://ap.wps.com/l/cbCailUF7D7a2zmW","pdf",2058041,11,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Keywords\n# Introduction","[{\"question\":\"What defines the “double-intra” pertrochanteric femur fracture pattern?\",\"answer\":\"It features intramedullary head–neck varus impaction and an anterior fracture line located intracapsularly, creating a distinct subtype of irreducible PFF.\"},{\"question\":\"How were fractures treated when closed reduction was insufficient?\",\"answer\":\"Closed reduction was attempted first and judged with Chang reduction quality criteria targeting “excellent” anteromedial cortical support. If this standard was not met, a limited open reduction technique using bone hooks and 2.5 mm K-wires was performed.\"},{\"question\":\"What were the main findings about anteromedial cortical support loss and follow-up outcomes?\",\"answer\":\"A 46.4% reduction loss rate occurred intraoperatively after fixation, with further AMCS loss on postoperative radiographs. At 3 months, the AMCS group showed lower ΔNSA, shorter implant sliding distance, and higher postoperative PPM scores than the non-AMCS group.\"}]","The “double-intra” pertrochanteric femur fracture: an irreducible and redisplaceable fracture pattern | PDF",1790749666,28]