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Wheeless' Textbook of Orthopaedics

Seinsheimer's Classification of Subtrochanteric Frxs



- Type I:
      - nondisplaced frx: < 2 mm of displacement of frx frags;

- Type II: two part fractures:
      - IIA: Two part transverse femoral fracture;
      - IIB: Two part spiral frx w/ lesser troch attached to prox frag;
      - IIC: Two part spiral frx w/ lesser troch attached to distal fragment;

- Type III: three part fractures:
      - IIIA:
          - three part spiral frx in which lesser troch is part of 3rd frag,
                which has an inferior spike of cortex of varying length;
          - implant failures and non-unions are common;
      - IIIB:
          - three part spiral frx of proximal 1/3 of femur, w/ third part
                butterfly fragment;
- Type IV:
      - comminuted frxs w/ 4 or more fragments;
      - implant failures and non-unions are common;
      - consider use of AO 95 deg Condylar Screw / Blade Plate:

- Type V:
      - subtrochanteric intertrochanteric fractures;
      - this group includes any subtroch frx w/ extension thru greater troch;
      - consider use of AO 95 deg Condylar Screw / Blade Plate:




Original Text by Clifford R. Wheeless, III, MD.