Intertrochanteric Fracture

Intertrochanteric fractures occur between the two bony prominences (trochanters) at the upper femur, just below the femoral neck. Like femoral neck fractures, they are most common in elderly women with osteoporosis after a ground-level fall. They are classified as stable or unstable based on whether the fracture pattern allows the fragments to bear load after fixation.

Unlike femoral neck fractures, the blood supply to the femoral head is rarely threatened by intertrochanteric fractures, so fixation — rather than replacement — is the most common surgical approach.

Presentation mirrors femoral neck fracture: inability to bear weight, shortened and externally rotated extremity, proximal thigh pain. AP pelvis and lateral hip X-rays are the primary imaging studies. CT is used for comminuted or complex patterns to plan fixation strategy.

Surgical fixation is the standard for virtually all intertrochanteric fractures in patients who can tolerate surgery. Early fixation (within 24–48 hours) improves outcomes.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Hip (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language