Trochanteric Proximal Femur Fractures


The trochanteric area is the extracapsular part (metaphysis) of the proximal femoral segment located between the base of the femoral neck and the distal level of the lesser trochanter. This area is typically attacked by osteoporosis in the elderly and contributes to high incidence of fracture. It is estimated that 125,000 hip fractures occur annually in the USA and that number could increase up to 250,000 by the year 2040. 90% of fractures occur in patients older than 65 years, and 75% are in women. Geriatric trochanteric fractures are one of the most common injuries encountered by orthopaedic surgeons. The vast majority of patients with trochanteric proximal femur fractures are treated with operative stabilization.

This article reviews the pathophysiology and clinical presentation of trochanteric proximal femur fractures and discusses three techniques in detail: dynamic hip screw fixation, arthroplasty, and intramedullary hip screw (IMHS). Video is available.

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