Executive Editor: Joseph Schatzker, Peter Trafton

Authors: Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken

Proximal femur - Trochanteric fracture, pertrochanteric, simple

General considerations

In extracapsular fractures there is minimal risk of osteonecrosis of the femoral head.

In simple pertrochanteric fractures the fracture line can begin anywhere on the greater trochanter and end either above or below the lesser trochanter. The medial cortex is interrupted in only one place.

These fractures cause significant shortening, but they are stable after reduction and fixation, largely because of the excellent contact of the fracture surfaces and lack of comminution. The lesser trochanter, the so-called medial buttress, is intact.

These fractures may be treated with a sliding hip screw and plate, or a cephalomedullary nail.

Note: Because healing of these fractures may take 12 or more weeks, if contraindications can be corrected soon enough, operative treatment of the fracture may be beneficial even if delayed. If definitive treatment will be delayed for more than 2 or 3 weeks, temporary skeletal traction might be considered to help maintain alignment.

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v2.0 2010-11-14