Intertrochanteric femur fracture: Difference between revisions

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==Background==
==Background==
*Occur via fall in elderly or osteoporotic


==Clinical Features==
==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==
==Differential Diagnosis==
{{Femur fracture types}}
{{Femur fracture types}}


==Diagnosis==
==Evaluation==
{{Proximal femur fracture diagnosis}}
 
===Evaluation===
[[File:Garden's Classification.jpg|thumb|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==
==Management==
{{General Fracture Management}}
===Specific Management===
*Ortho consult


==Disposition==
==Disposition==
*Admit
===Specialty Care===
*Typically requires ORIF


==See Also==
==See Also==
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<references/>
<references/>


===Intertrochanteric===
[[Category:Orthopedics]]
[[File:Garden's Classification.jpg|thumb|Garden's classification of intertrochanteric fractures]]
*Occur via fall in elderly or osteoporotic
*Typically pain, swelling, ecchymosis
**May lose 1-2L of blood
*Unable to bear weight
*Shortening and external rotation if fracture is significantly displaced
*Types:
**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

Revision as of 05:43, 18 September 2019

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 Fracture Types

Proximal

Shaft

Evaluation

Hip fracture classification.
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

General Fracture Management

Specific Management

  • Ortho consult

Disposition

  • Admit

Specialty Care

  • Typically requires ORIF

See Also

External Links

References