Difference between revisions of "Intertrochanteric femur fracture"

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==Background==
 
==Background==
 +
*Occur via fall in elderly or osteoporotic
  
 
==Clinical Features==
 
==Clinical Features==
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*Typically pain, swelling, ecchymosis
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**May lose 1-2L of blood
 +
*Unable to bear weight
 +
*Shortening and external rotation if fracture is significantly displaced
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Femur fracture types}}
 
{{Femur fracture types}}
  
==Diagnosis==
+
==Evaluation==
 
{{Proximal femur fracture diagnosis}}
 
{{Proximal femur fracture diagnosis}}
 +
 +
===Evaluation===
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[[File:Garden's Classification.jpg|thumb|Garden's classification of intertrochanteric fractures]]
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*Stable (Garden's type I and II)
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**Lesser trochanter non-displaced, no comminution, medial cortices of prox/distal fragments aligned
 +
*Unstable (Garden's type III and IV)
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**Displacement occurs, comminution is present, or multiple fracture lines exist
  
 
==Management==
 
==Management==
 +
{{General Fracture Management}}
 +
 +
===Specific Management===
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*Ortho consult
  
 
==Disposition==
 
==Disposition==
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*Admit
 +
 +
===Specialty Care===
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*Typically requires ORIF
  
 
==See Also==
 
==See Also==
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<references/>
 
<references/>
  
===Intertrochanteric===
+
[[Category:Orthopedics]]
[[File:Garden's Classification.jpg|thumb|Garden's classification of intertrochanteric fractures]]
 
*Occur via fall in elderly or osteoporotic
 
*Typically pain, swelling, ecchymosis
 
**May lose 1-2L of blood
 
*Unable to bear weight
 
*Shortening and external rotation if fracture is significantly displaced
 
*Types:
 
**Stable (Garden's type I and II)
 
***Lesser trochanter non-displaced, no comminution, medial cortices of prox/distal fragments aligned
 
**Unstable (Garden's type III and IV)
 
***Displacement occurs, comminution is present, or multiple fracture lines exist
 
*Management
 
**Admit for eventual ORIF
 

Latest revision as of 05:43, 18 September 2019

Background

  • Occur via fall in elderly or osteoporotic

Clinical Features

  • Typically pain, swelling, ecchymosis
    • May lose 1-2L of blood
  • Unable to bear weight
  • Shortening and external rotation if fracture is significantly displaced

Differential Diagnosis

Femur fractures

Proximal

Shaft

Evaluation

Location of femur fractures
  • Consider AP pelvis in addition to AP/lateral views to compare contralateral side
  • Consider MRI if strong clinical suspicion but negative x-ray

Evaluation

Garden's classification of intertrochanteric fractures
  • Stable (Garden's type I and II)
    • Lesser trochanter non-displaced, no comminution, medial cortices of prox/distal fragments aligned
  • Unstable (Garden's type III and IV)
    • Displacement occurs, comminution is present, or multiple fracture lines exist

Management

General Fracture Management

Specific Management

  • Ortho consult

Disposition

  • Admit

Specialty Care

  • Typically requires ORIF

See Also

External Links

References