Skeletal Radiology

, Volume 48, Issue 1, pp 29–45 | Cite as

Fragility fractures of the proximal femur: review and update for radiologists

  • Kimia Khalatbari KaniEmail author
  • Jack A. Porrino
  • Hyojeong Mulcahy
  • Felix S. Chew
Review Article


Proximal femoral fragility fractures are common and result in significant morbidity and mortality along with a considerable socioeconomic burden. The goals of this article are to review relevant proximal femoral anatomy together with imaging, classification, and management of proximal femoral fragility fractures, and their most common complications. Imaging plays an integral role in classification, management and follow-up of proximal femoral fragility fractures. Classification of proximal femoral fragility fractures is primarily based on anteroposterior hip radiographs. Pertinent imaging features for each category of proximal femoral fractures that would guide management are: differentiating nondisplaced from displaced femoral neck fractures, distinguishing stable from unstable intertrochanteric fractures, and determining the morphology and comminution of subtrochanteric fractures. Treatment of proximal femoral fragility fractures is primarily surgical with either arthroplasty or internal fixation. Intramedullary nailing is used in the treatment of some types of proximal femoral fragility fractures and may be associated with unique complications that become evident on postoperative follow-up radiographs.


Hip fracture Proximal femur fracture Fragility fracture Femoral neck fracture Intertrochanteric fracture Subtrochanteric fracture Sliding hip screw Intramedullary nail Cephalomedullary nail 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© ISS 2018

Authors and Affiliations

  • Kimia Khalatbari Kani
    • 1
    Email author
  • Jack A. Porrino
    • 2
  • Hyojeong Mulcahy
    • 3
  • Felix S. Chew
    • 3
  1. 1.Department of RadiologyUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of RadiologyUniversity of WashingtonSeattleUSA
  3. 3.Radiology and Biomedical ImagingYale School of MedicineNew HavenUSA

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