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Sub-trochanteric fractures generally have a good prognosis due to the good supply of blood and adequate collateral circulation to this region of the femur with a low incidence of avascular necrosis and non-union. The Zickel classification (modified from Fielding) of subtrochanteric fractures takes into consideration the level and obliquity of the fracture line as well as the presence or absence of comminution. Type III: within the region 2.5 cm to 5 cm below the lesser trochanter (least common) Im using 27248 for the nailing, but Im stuck on the ICD-9. The patient has a lesion on his femur after a diagnosis of prostate cancer and the doc is putting in an intermedullary nail prior to radiation treatment. Type II: within the region 2.5 cm below the lesser trochanter Best answers 0 1 Anyone psychic out there My Dr is, hes giving me a dx of 'Left femur impending pathologic fracture'. Type I: at the level of the lesser trochanter (most common) The Fielding classification of subtrochanteric fractures is based on the level of the subtrochanteric region through which the fracture extends: Type IV: posteromedial comminution, the shaft is laterally displaced Type III variant: type III combined with greater trochanter fracture Type III: posteromedial comminution, the shaft is medially displaced with the neck beak impacted into it Type II: no posteromedial comminution, lesser trochanter may be fractured The Tronzo classification is another classification system Type IV: oblique fracture of the shaft with extension into the subtrochanteric region Type III: with comminution associated with the subtrochanteric component Type II: with comminution of trochanteric region The Boyd and Griffin classification is based on the involvement of subtrochanteric region: Multi-part with comminution of both trochanters and intertrochanteric region Three-part with comminution of lesser trochanter or greater trochanterįour-part with comminution of both trochanters Two-part linear intertrochanteric fracture stable They are subdivided according to the number of fragments, as follows: Pertrochanteric: intertrochanteric, involving both trochanters Classificationįractures in these regions can be classified as: A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.