31-A1 Trochanteric avulsion
31-A1
Type A1 fractures are avulsion of the greater trochanter.
Fracture of the greater trochanter and distal femoral fracture.
General considerations
High-velocity injuries of the proximal femur generally result in intertrochanteric or subtrochanteric comminuted fractures. Low-velocity injuries result in lower energy fractures and often result in two-piece fractures such as capital physeal fractures, femoral neck fractures or transverse fractures of the subtrochanteric region.
The small bone stock available for fixation in the proximal femoral fractures makes treatment of this type of fractures challenging.
31-B fractures are simple fractures of the femoral neck. These fractures may or may not be displaced. Fixation should be performed as soon as possible to avoid abrasion damage and resorption of the femoral neck, making reduction difficult.
Cervical fractures can be intracapsular or extracapsular.
In very young animals, fractures of the greater trochanter may occur concurrently to a capital physeal fractures.
Etiology
31-A1 and A2 type fractures generally result from low energy trauma, whereas A3 fractures are caused by high energy trauma.
Fractures of the greater trochanter occur in young animals, often associated to capital physeal fractures.
Clinical signs
Clinical signs observed in 31-A fractures are:
- Pain
- Crepitus during manipulation of the hip joint
- Non weight bearing of the affected limb
Imaging
Good quality mediolateral and craniocaudal radiographs are essential for fracture evaluation.
In A1 fractures the avulsed fragment may be overlapped by the femur, making diagnosis challenging. In some fractures, the abducted ventro-dorsal view (frog leg) may provide useful additional information.
For complex fractures, computed tomography should be considered.
