Intertrochanteric fractures are common problem especially in the elderly and are becoming more frequent as the proportion of the elderly in the population increases. Sometimes these fractures can become life-threatening disasters during or after treatment in the elderly.
Surgery is the treatment of choice for both stable and unstable intertrochanteric fractures, with the goal of stable fixation to allow early mobilization and to restore the patient's previous level of activity. Dynamic hip screws have been widely used for the treatment of these fractures because of their biomechanical advantages. Factors contributing to fixation failures in intertrochanteric fractures using dynamic hip screws are facture stability, comminution, osteoporosis, the type of reduction and surgical techniques. These factors have been involved in the difficulty in achieving and maintaining stable reduction and rigid internal fixation of unstable fractures. There are many classification systems for these fractures based on plain X-ray findings including the Evans system, the Jensen's system, the AO/OTA system, and the Boyd and Griffin system. Nakano proposed a 3D-CT classification system in Japan to avoid misunderstanding of the fracture pattern by plain X-rays because femoral trochanteric fractures are sometimes very difficult to precisely diagnose.