Intertrochanteric femur fracture
Background
Clinical Features
Differential Diagnosis
Femur Fracture Types
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Diagnosis
- Consider AP pelvis in addition to AP/lateral views to compare contralateral side
- Consider MRI if strong clinical suspicion but negative x-ray
Management
Disposition
See Also
External Links
References
Intertrochanteric
- 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
- Stable (Garden's type I and II)
- Management
- Admit for eventual ORIF