An intertrochanteric hip fracture occurs lower than a femoral neck fracture. Intertrochanteric hip fractures have a different treatment because they do not have the issues with damage to blood flow to bone seen with the femoral neck fractures. Because the bone blood flow is usually in tact, these fractures can usually be repaired, and do not require the hip replacement procedure described previously.
Treatment of Intertrochanteric Fractures
Intertrochanteric fractures are usually repaired with a metal plate and screws. The patient is given a general or spinal anesthesia in the operating room. They are then positioned in a manner to realign the fractured bone. Once the fracture is well positioned and confirmed to be in a good position using x-ray, an incision is made on the outside of the thigh. The femur (thigh bone) is exposed, and a metal plate is placed along the outside of the thigh bone using several small screws. A large screw is inserted across the fracture and into the femoral head. This large screw is held to the plate. Together, this plate and screw implant holds the broken bones in place.
Throughout the procedure, your surgeon will use x-ray to confirm the position of the implants and ensure the fracture is well aligned. The incision is about 8 centimeters long.
Some surgeons are using a newer implant that uses some of the same principles described here, but uses a rod inserted down the center of the bone rather than a plate along the outside of the bone. Both types of fracture fixation (the plate and the rod) have shown good healing and have had excellent results.
Rehab After Intertrochanteric Fractures
Patients are usually allowed to begin walking immediately following surgery. In some cases, if there were small fracture fragments or difficulty with alignment of the fracture, weight may be restricted. Most commonly, patients will get up with the physical therapist within a day following surgery. Time for complete healing is usually about 12 weeks, but most patients are walking well before that time.