Irreducible intertrochanteric fractures of the femur.

A retrospective study during a 3-year interval revealed that four of 112 patients had intertrochanteric fractures that were irreducible by the usual closed manipulation and traction techniques at the time of surgery. Each of these patients' preoperative radiographs showed a fracture line that bisected the lesser trochanter and was relatively uncomminuted. Although longitudinal traction and appropriate closed manipulation provide acceptable reduction for most intertrochanteric fractures, the few with the described fracture pattern may require open reduction with removal of interposed soft tissue to achieve satisfactory alignment.