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Inter-trochanteric Hip Fractures

    Inter-trochanteric Hip Fractures

    Hip fractures are a common problem for our elderly population.  They typically result from a fall.  In younger patients, much more energy is required to break the hip, so these types of fractures are much less common in this patient population.  The hip is a ball and socket joint.  The term hip fracture refers to a break in the top part of the femur, which becomes the ball portion of the joint. The hip can break on the neck right next to the ball or further down where the neck joins the shaft of the femur.  These fractures are termed femoral neck fractures and Inter-trochanteric hip fractures respectively.

    Essentially, all inter-trochanteric hip fractures are treated surgically.  Non-surgical treatment is reserved only for those far too sick to tolerate anaesthesia/surgery, but even then great consideration is given for surgery for palliative reasons. Our  goal with surgery is to stabilize the fracture so that the patient can get moving and out of bed as soon as possible.  This diminishes the complications of prolonged immobility such as bed sores, pneumonia, blood clots, and muscle de-conditioning.

    There are two different type of fracture implants used to stabilize inter-trochanteric hip fracture:  nails that go down the shaft of the femur and plates which attach to the side.  The goal of the implant is to hold the fracture ends together in a manner that provides enough rigidity and stability to allow the patient to ambulate.  The fracture takes usually eight weeks to heal depending on the severity of the fracture.  Physical therapy and rehabilitation is a very important element in the recovery.  

    These fractures can be very difficult for patients and their families.  Often after hip fractures, patients can lose one level of ambulation.  In other words, if they walked independently before, they may require a cane after they heal.  If they used a cane, they may need a walker.  These fractures are a tremendous physical stress for a patient and an emotional stress for the family.  Often patients loose some level of independence and may require some level of assisted living after.