ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1637763
Impact of Fracture Reduction Quality on Clinical Outcomes in Hip Arthroplasty for Intertrochanteric Fractures Based on A Novel Radiographic Evaluation System: A Retrospective Study
Provisionally accepted
- Third Hospital of Hebei Medical University, Shijiazhuang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
The impact of fracture reduction quality on clinical outcomes in hip arthroplasty for intertrochanteric fractures remains insufficiently characterized. This study aimed to establish a standardized postoperative radiographic evaluation system for reduction quality and assess its correlation with postoperative function and complications.Methods: A retrospective cohort study included 237 patients undergoing hip arthroplasty for intertrochanteric fractures (2012-2024). Reduction quality was classified as optimal, acceptable, or poor based on four criteria:(1) greater trochanter alignment, (2) lesser trochanter reduction, (3) femoral stem stability, and (4) postoperative femoral anteversion (optimal: 13±3°; acceptable: 6-10° or 16-20°; poor: <6° or >20°). Outcomes included Harris Hip Scores, Engh's scores, delayed healing, and complications. Statistical analyses were adjusted for AO/OTA fracture classification.Results: Optimal reduction (Grade A, n=107) correlated with superior Harris Hip Scores (92.57±4.27 vs. 82.46±7.05, P<0.001), lower delayed healing (3.74% vs. 14.29%, P=0.031), and reduced abductor weakness (1.87% vs. 14.29%, P=0.014). Acceptable reductions (Grade B, n=74) showed intermediate outcomes. Poor reductions (Grade C, n=56) exhibited the highest complication rates. Engh's scores were significantly higher in Grade A (97.20% vs. 73.21%, P=0.002). Dislocation and heterotopic ossification rates did not differ significantly (P>0.05).This study introduced and validated a standardized radiographic evaluation system to assess reduction quality in arthroplasty for intertrochanteric fractures, emphasizing the prognostic importance of anatomic trochanteric alignment and cortical continuity. High-quality reduction is critical for optimizing functional recovery and minimizing complications in arthroplasty for intertrochanteric fractures. Future research should explore long-term outcomes and advanced fixation techniques to enhance reduction precision.
Keywords: ：reduction, Fracture, Hip, Arthroplasty, Radiographic
Received: 29 May 2025; Accepted: 26 Jul 2025.
Copyright: © 2025 Zhang, Huo and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huijie Li, Third Hospital of Hebei Medical University, Shijiazhuang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.