II. Pathophysiology
- Images
- Extracapsular Hip Fracture
- Contrast with Femoral Neck Fracture
- Mechanism of injury
- High speed accident
- Fall from height
III. Diagnosis
- See Hip Fracture
-
Fracture line between greater and lesser trochanters
- Above Subtrochanteric Fracture
- Below Femoral Neck Fracture
IV. Management
- See Hip Fracture
- Evaluate for associated injuries (see pitfalls below)
- Strongly consider regional Nerve Block (Fascia Iliaca Block or PENG Block) in hip and Femur Fractures
- Closely manage fluid status
- Initial Resuscitation with isotonic crystalloid
- Type and Cross for 2 Units pRBC
- Continually reassess hemodynamic status
- Open reduction and internal fixation
- Surgery within 48 hours of injury
V. Complications
- Significant blood loss and hemodynamic instability
VI. Pitfalls
- Elderly are often significantly dehydrated
- Associated injuries are common
- Distal Radius Fracture
- Proximal Humerus Fracture
- Rib Fracture
- Spinal compression Fractures (esp. T12 and L1)
VII. Prognosis
- High mortality in first year: Up to 30%
VIII. References
- Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60
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Related Studies
Concepts | Injury or Poisoning (T037) |
MSH | D006620 |
ICD10 | S72.14 |
SnomedCT | 127287001 |
English | Fractures, Intertrochanteric, Intertrochanteric frac femur, femur fracture intertrochanteric, fracture intertrochanteric, intertrochanteric fractures, femur fractures intertrochanteric, intertrochanteric fracture, intertrochanteric fracture of femur, intertrochanteric fracture of femur (diagnosis), fracture of neck of femur intertrochanteric, Intertrochanteric fracture of femur, Intertrochanteric fracture (disorder), Intertrochanteric fracture, femur; fracture, intertrochanteric, intertrochanteric; femoral fracture, Intertrochanteric Fractures |
Portuguese | Fraturas Intertrocantéricas |
French | Fractures transtrochantériennes, Fractures trans-trochantériennes |
German | Intertrochantäre Frakturen |
Spanish | Fracturas Intertrocanterianas, fractura intertrocantérea (trastorno), fractura intertrocantérea |
Italian | Fratture intertrocanteriche |
Norwegian | Intertrokantærfrakturer, Fractura intertrochanterica femoris, Intertrokantært brudd |
Dutch | femur; fractuur, intertrochantair, intertrochantair; femurfractuur, Fractuur, intertrochantere |