An intertrochanteric fracture is a specific type of hip fracture. “Intertrochanteric” means “between the trochanters,” which are bony protrusions on the femur (thighbone). They’re the points where the muscles of the thigh and hip attach.
There are two trochanters in the body: the greater trochanter and the lesser trochanter. An intertrochanteric fracture occurs between the greater and lesser trochanters.
Intertrochanteric fractures are common. About 50 percent of all hip fractures caused by problems such as falling are intertrochanteric.
The most common symptoms of intertrochanteric fractures include:
- severe pain in the hip
- not being able to put weight on the injured side’s leg
- not being able to move or stand up after a fall
- bruising and swelling around the hip
- stiffness and pain in the leg of the injured side
- having a leg in an unnatural position or turned to the injured side
The most common causes of intertrochanteric fractures are falls or trauma. These problems are more likely to occur among older people, who are at a higher risk of falling. In some cases, people who have weak bones can get a fracture from simply walking or standing. Car crashes and other accidents can also cause hip fractures.
The risk factors for intertrochanteric fractures include:
- being female
- being older than 60
- having a history of falls
- having osteoporosis
- having a history of other bone problems or fractures
- having low bone density and low muscle mass
- having problems with walking or balance
How it’s diagnosed
Your doctor will ask about your medical history and do a physical exam. Then, they’ll likely order X-rays or other imaging tests to diagnose an intertrochanteric fracture. The most common tests for diagnosis of an intertrochanteric fracture include:
Usually, X-rays provide enough information for your doctor to diagnose a hip fracture. However, small hairline fractures may not show up on X-rays, so other imaging tests may be necessary. Your doctor will determine the right imaging tests for your condition.
The most common treatment for intertrochanteric fractures is surgery. In most cases, surgery is recommended because this fracture can take a long time to heal on its own. One of the most common surgical treatments for this type of hip fracture is an open reduction and internal fixation (ORIF). This is a type of surgery that puts the broken bone in place and fixes it with screws, rods, pins, or plates.
However, surgery may not be an option if you have bleeding problems or can’t tolerate anesthesia.
What to expect from recovery
Recovery time can vary based on your age and other medical problems. It can take three months or longer to recover from a hip fracture.
After surgery, you may go to a rehabilitation center or extended care facility to recover. You’ll work with physical and occupational therapists to improve your mobility and strength. They’ll have you do a variety of exercises while you recover. You may work on walking and standing. You may also focus on activities to help you take care of yourself, such as bathing, dressing, and other daily activities. You may spend three to six months or longer working with a physical therapist.
You may also have to take medications such as blood thinners after surgery and while you recover. Make sure you follow all of your doctor’s instructions and take the required medications to improve your recovery.
Intertrochanteric fractures usually affect older people who have a history of osteoporosis or other bone problems. This type of hip fracture is rare among younger adults. Your doctor will decide the best treatment options for you. Surgery is the most common treatment for intertrochanteric fractures.
Some people make a full recovery and return to normal activities after several months. You may regain full strength and be able to do the same things as before.