Intertrochanteric hip fractures are a type of proximal femur fracture that occurs in the region between the neck and the shaft of the femur, specifically involving the intertrochanteric area where the greater and lesser trochanters are located. These fractures are commonly seen in elderly patients, particularly those with osteoporosis, which weakens the bone structure and makes it more susceptible to breaks. The mechanism of injury for intertrochanteric hip fractures is often due to low-energy falls, which are frequent in older adults who may have balance issues, muscle weakness, or visual impairment. However, these fractures can also occur in younger individuals as a result of high-energy traumas, such as car accidents or sports injuries. The clinical presentation typically includes severe pain in the hip or groin, inability to bear weight on the affected leg, and a characteristic position of the leg, which may appear externally rotated and shortened. Diagnosis is primarily achieved through radiographic evaluation, including X-rays that demonstrate the fracture's location and displacement. In some cases, a CT scan may be required for better assessment. Treatment options depend on the fracture's type and displacement but generally involve surgical intervention to restore stability and facilitate early mobilization. Common surgical techniques include intramedullary nailing or sliding hip screws, both aimed at providing fixation to allow the bone to heal effectively. Postoperative rehabilitation is crucial and often includes physical therapy to regain strength and mobility. Without surgical intervention, intertrochanteric fractures can lead to significant complications, including nonunion, malunion, and a high risk of morbidity due to prolonged immobilization, which can increase the likelihood of complications such as pneumonia, deep vein thrombosis, and pressure ulcers. Given the aging population, the incidence of intertrochanteric hip fractures is expected to rise, making understanding, prevention, and effective management increasingly vital in clinical practice. Prevention strategies, particularly in the elderly, may include fall prevention programs, home safety assessments, and the use of medications or supplements to improve bone density. Recognizing the impact of these fractures on the patient's overall health and quality of life is essential, as they can lead to functional decline, loss of independence, and increased mortality risk. Therefore, a comprehensive approach encompassing public health initiatives and individualized patient care is important for the effective management of intertrochanteric hip fractures in the aging population.
