Diagnosis

Trochanteric fracture, intertrochanteric 

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Trochanteric fracture, intertrochanteric

Trochanteric fracture, intertrochanteric

These are true intertrochanteric fractures. The fracture line passes between the two trochanters, above the lesser trochanter medially and below the crest of the vastus lateralis laterally. Both femoral cortices are involved.

The so-called reverse oblique fractures often have a typical displacement because of the pull of the abductors which abduct and flex the proximal fragment. Be careful in determining the distal extension of the fracture line as fissures far down into the femoral shaft are not uncommon.

Transverse intertrochanteric fractures may be simple, wedge or multifragmentary.

Trochanteric fracture, intertrochanteric

Trochanteric fracture, intertrochanteric

X-rays taken from Orozco R et al, (1998) Atlas of Internal Fixation. Used with kind permission.