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Intertrochanteric Fracture

Aka: Intertrochanteric Fracture

See Also
1. Hip Fracture
Pathophysiology
1. Extracapsular Hip Fracture
  1. Contrast with Femoral Neck Fracture
2. Mechanism of injury
  1. High speed accident
  2. Fall from height
Diagnosis
1. See Hip Fracture
2. Fracture line between greater and lesser trochanters
  1. Above Subtrochanteric Fracture
  2. Below Femoral Neck Fracture
Management
1. Evaluate for associated injuries (see pitfalls below)
2. Closely manage fluid status
  1. Initial Resuscitation with isotonic crystalloid
  2. Type and Cross for 2 Units pRBC
  3. Continually reassess hemodynamic status
3. Open reduction and internal fixation
  1. Surgery within 48 hours of injury
Complications
1. Significant blood loss and hemodynamic instability
Pitfalls
1. Elderly are often significantly dehydrated
2. Associated injuries are common
  1. Distal Radius Fracture
  2. Proximal Humerus Fracture
  3. Rib Fracture
  4. Spinal compression Fractures (esp. T12 and L1)
Prognosis
1. High mortality in first year: Up to 30%
References
1. Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook