{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:11:46Z","timestamp":1780719106939,"version":"3.54.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of fracture reduction quality on clinical outcomes in hip arthroplasty for intertrochanteric fractures remains insufficiently characterized. This study aimed to establish a standardized postoperative radiographic evaluation system for reduction quality and assess its correlation with postoperative function and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study included 237 patients undergoing hip arthroplasty for intertrochanteric fractures (2012\u20132024). Reduction quality was classified as optimal, acceptable, or poor based on four criteria: (1) greater trochanter alignment, (2) lesser trochanter reduction, (3) femoral stem stability, and (4) postoperative femoral anteversion (optimal: 13 \u00b1 3\u00b0; acceptable: 6\u201310\u00b0 or 16\u201320\u00b0; poor: &amp;lt;6\u00b0 or &amp;gt;20\u00b0). Outcomes included Harris Hip Scores, Engh's scores, delayed healing, and complications. Statistical analyses were adjusted for AO\/OTA fracture classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Optimal reduction (Grade A, <jats:italic>n<\/jats:italic> = 107) correlated with superior Harris Hip Scores (92.57 \u00b1 4.27 vs. 82.46 \u00b1 7.05, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), lower delayed healing (3.74% vs. 14.29%, <jats:italic>P<\/jats:italic> = 0.031), and reduced abductor weakness (1.87% vs. 14.29%, <jats:italic>P<\/jats:italic> = 0.014). Acceptable reductions (Grade B, <jats:italic>n<\/jats:italic> = 74) showed intermediate outcomes. Poor reductions (Grade C, <jats:italic>n<\/jats:italic> = 56) exhibited the highest complication rates. Engh's scores were significantly higher in Grade A (97.20% vs. 73.21%, <jats:italic>P<\/jats:italic> = 0.002). Dislocation and heterotopic ossification rates did not differ significantly (<jats:italic>P<\/jats:italic> &amp;gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study introduced and validated a standardized radiographic evaluation system to assess reduction quality in arthroplasty for intertrochanteric fractures, emphasizing the prognostic importance of anatomic trochanteric alignment and cortical continuity. High-quality reduction is critical for optimizing functional recovery and minimizing complications in arthroplasty for intertrochanteric fractures. Future research should explore long-term outcomes and advanced fixation techniques to enhance reduction precision.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1637763","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:33:48Z","timestamp":1755149628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of fracture reduction quality on clinical outcomes in hip arthroplasty for intertrochanteric fractures based on a novel radiographic evaluation system: a retrospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Binquan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Huo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1056\/NEJMcp1611090","article-title":"Management of acute hip fracture","volume":"377","author":"Bhandari","year":"2017","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1302\/0301-620X.89B4.18552","article-title":"Mortality and mobility after hip fracture in Japan: a ten-year follow-up","volume":"89","author":"Tsuboi","year":"2007","journal-title":"J Bone Joint Surg Br"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1007\/s00198-009-0920-3","article-title":"Excess mortality following hip fracture: a systematic epidemiological review","volume":"20","author":"Abrahamsen","year":"2009","journal-title":"Osteoporos Int."},{"key":"B4","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.bone.2013.05.015","article-title":"Excess mortality after hip fracture among the elderly in Taiwan: a nationwide population-based cohort study","volume":"56","author":"Wang","year":"2013","journal-title":"Bone."},{"key":"B5","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1097\/00003086-199609000-00020","article-title":"Patients with femoral neck and intertrochanteric fractures. 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