What Is a Trochanteric Fracture?

A femoral intertrochanteric fracture is a fracture that occurs from the base of the femoral neck to the level above the trochanter. It is also a common injury for the elderly. Due to the abundant blood circulation in the trochanter, it is rarely unhealed after a fracture.

Basic Information

English name: intertrochanteric fractures of femur
Visiting department: orthopedics
Multiple groups: Seniors
Common locations: Base of femoral neck to level above trochanter

Common causes: Direct and indirect violence
Common symptoms: Rotor area pain, swelling, blood spots, restricted lower limb movements, tenderness, obvious lower limb external rotation deformity, up to 90 °, axial throbbing pain, lower limb shortening

Causes of femoral intertrochanteric fractures

Intertrochanteric fractures can be caused by indirect or direct violent effects. When a fall occurs, the body rotates, falls to the ground in excessive abduction or adduction, or falls to the side during a fall. The large trochanter directly strikes, and intertrochanteric fractures can occur. . This is one of the most common sites of bone cystic lesions, so pathological fractures can also occur.

Clinical manifestations of femoral intertrochanteric fractures

After the injury, pain appeared in the trochanteric area, swelling, congestion, and restricted lower limb movements. Examination revealed tenderness between the trochanters, obvious external rotation deformities of the lower limbs, up to 90 °, and axial throbbing pain. Measurements revealed lower limb shortening.

Intertrochanteric fracture examination

X-rays can clarify the type and displacement of the fracture.

Diagnosis of femoral intertrochanteric fractures

Make a diagnosis based on clinical manifestations and related tests.

Treatment of femoral intertrochanteric fractures

Treatment plan

After traction reduction, she was absolutely bed-rested and had a strong external fixation with plaster and braces. The fixation time was about 8 weeks. Or surgical incision and reduction and internal fixation are more effective and can reduce complications.

2. Principles of treatment

(1) Treatment of comorbidities A comprehensive and systematic examination of the elderly, the detection of comorbidities and the corresponding treatment are the key to reducing surgical complications and improving the success rate of surgery. If the elderly medical comorbidities involve multiple systems, the treatment is more complicated. It is best to cooperate with the relevant departments to quickly and effectively control the comorbidities in order to effectively prevent complications.

(2) Although some patients have femoral intertrochanteric fractures and have the ability to take care of themselves, if they stay in bed for a long time after a fracture, they will reduce their opportunities for active exercise, further worsen the original chronic diseases, increase the risk of surgery, and even lose Opportunity for surgery. Therefore, elderly femoral intertrochanteric fractures should be operated as soon as possible to shorten the preoperative preparation time.

(3) Choice of anesthesia method Anesthesia method with little effect on the respiratory and circulatory systems, short-term effect and strong controllability is preferred. Continuous epidural anesthesia is more suitable for elderly patients, and local anesthesia can also be selected.