33 years male with pain over left hip with limited range of movement following a road traffic accident.
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Comminuted intertrochanteric fracture involving the left proximal femur with internal rotation the femur
Intertrochanteric fractures are a common injury of the proximal femur, and are classed as an extracapsular femoral neck fracture. The Boyd and Griffin scale was the first system to attempt to classify these fractures but since simpler Evans and AO classifications have also been proposed.
In those between 11-60 years men sustain these injuries more commonly then women while above 60 years these occur twice as commonly in women where osteoporosis is a significant consideration.
While the dynamic hip screw was the traditional mainstay of surgical management for these fractures more recently intramedullary fixationa nails and compression plate devices have been developed for treatment. The exact prosthesis choice varies depending on the patient.
- 1. Lee SR, Kim ST, Yoon MG et-al. The stability score of the intramedullary nailed intertrochanteric fractures: stability of nailed fracture and postoperative patient mobilization. Clin Orthop Surg. 2013;5 (1): 10-8. doi:10.4055/cios.2013.5.1.10 - Free text at pubmed - Pubmed citation
- 2. Anglen JO, Weinstein JN. Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database. J Bone Joint Surg Am. 2008;90 (4): 700-7. doi:10.2106/JBJS.G.00517 - Pubmed citation
- 3. Orthoguidelines.org. 'OrthoGuidelines', 2015. [Link].