Does a Traction/Internal Rotation Radiograph Improve Accuracy?
Purpose: We determined whether a traction/internal rotation radiograph aids in the accurate classification of proximal femur fractures. The standard radiographic series for evaluation of suspected hip fractures in most centers includes an AP radiograph of the pelvis as well as AP and cross-table lateral views of the hip. The natural femoral neck anteversion as well as the fracture deformity may, however, make accurate fracture classification difficult. We have noted that inexperienced physicians sometimes misclassify hip fractures on the basis of the initial radiographic series, and this may lead to errors both in surgical planning and implant choice. In this study, we examined the usefulness of routinely obtaining a traction/internal rotation radiograph in the classification of proximal femur fractures by junior residents in our orthopaedic residency program. Methods: Forty-seven sets of complete radiographs (AP pelvis, AP hip, cross-table lateral, traction/internal rotation views) we
