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12. Inter trochanteric fracture

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Dr. Bindesh Patel (MPTh)

An intertrochanteric fracture occurs in the area between the greater and lesser trochanters of the femur. It is usually caused by a minor fall in elderly patients and major trauma in adults. Diagnosis is made through clinical examination finding pain and inability to move the leg as well as x-ray showing comminution of the medial femoral cortex. Treatment options include conservative methods like traction or operative fixation using devices like dynamic hip screws or gamma nails to maintain the normal femoral neck shaft angle and allow healing. Complications can include malunion leading to limping or shortening and osteoarthritis from changes in hip biomechanics.

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By :- Dr. Bindesh D. Patel, PT Deputy Registrar P P Savani University Inter-trochanteric fracture
• May involve either greater trochanter or lesser trochanter or both • Elderly by minor force • Adult by major force • Femoral neck shaft angle is reduced (Coxa vara) • Comminuted and displaced fracture • Very rarely undisplaced fracture
Diagnosis • Clinical features • History of fall or accident • Pain, swelling, tenderness • Inability to move leg • Physical findings are more marked compared to neck of femur fracture
• Easy to diagnose on X-ray • Comminution of the medial cortex of the neck of femur • Avulsion of lesser trochanter • Extension of the fracture of the sub trochanteric region indicates unstable fracture and poor prognosis
Treatment • It unites readily • Main objective is to maintain a normal femoral neck shaft angle • In elderly patient, ORIF is preferred to prevent complications
• Conservative method – Russell’s traction and – Thomas splint
• Operative method – Internal fixation used are • Dynamic Hip Screw • Ender’s nail • Gamma nail – External fixation is used for patients with bed sores
12. Inter trochanteric fracture
12. Inter trochanteric fracture
Complications • Malunion – Coxa vara – Elderly mild limping while walking and shortening – Suitable shoe raise – Adult – Corrective osteotomy
• Osteoarthritis – Due to change in hip biomechanics – Pain and stiffness – Physiotherapy treatment – Later trochanteric osteotomy or THR
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12. Inter trochanteric fracture

  • 1. By :- Dr. Bindesh D. Patel, PT Deputy Registrar P P Savani University Inter-trochanteric fracture
  • 2. • May involve either greater trochanter or lesser trochanter or both • Elderly by minor force • Adult by major force • Femoral neck shaft angle is reduced (Coxa vara) • Comminuted and displaced fracture • Very rarely undisplaced fracture
  • 3. Diagnosis • Clinical features • History of fall or accident • Pain, swelling, tenderness • Inability to move leg • Physical findings are more marked compared to neck of femur fracture
  • 4. • Easy to diagnose on X-ray • Comminution of the medial cortex of the neck of femur • Avulsion of lesser trochanter • Extension of the fracture of the sub trochanteric region indicates unstable fracture and poor prognosis
  • 5. Treatment • It unites readily • Main objective is to maintain a normal femoral neck shaft angle • In elderly patient, ORIF is preferred to prevent complications
  • 6. • Conservative method – Russell’s traction and – Thomas splint
  • 7. • Operative method – Internal fixation used are • Dynamic Hip Screw • Ender’s nail • Gamma nail – External fixation is used for patients with bed sores
  • 10. Complications • Malunion – Coxa vara – Elderly mild limping while walking and shortening – Suitable shoe raise – Adult – Corrective osteotomy
  • 11. • Osteoarthritis – Due to change in hip biomechanics – Pain and stiffness – Physiotherapy treatment – Later trochanteric osteotomy or THR
  • 13. Please share the video and subscribe my channel.