Fractures of the Upper End of the Femur in the Aged

Abstract

(1) Fractures in the region of the neck of the femur are usually subdivided into the intra- and extra-capsular variety. This classification is faulty and misleading. (2) An analysis of the injuries, in the region examined in this series, shows them to be readily classifiable into five types. Although certain authors have attempted to subdivide the trochanteric variety into two, I am of the opinion that this is not practicable, since a large proportion are true neither to the intertrochanteric nor to the pertrochanteric type. (3) Since the great majority, at least, of the trochanteric fractures would, according to the older classification, have been called “extra-capsular,” and since it is stated that this type occurs generally in muscular adults and infrequently in old age, the large proportion found in this series directly contradicts the modern teaching. (4) It is submitted that even trochanteric (the so-called extra-capsular) fractures are not due to direct external violence in the aged. The suggested ...