Intertrochanteric femur fracture

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

  • Admit for eventual ORIF

Disposition

  • Admit

See Also

External Links

References