Trochanteric fracture

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  • AP view in internal rotation
  • Buck’s traction
  • Hip spica
  • bohlerbraun frame
  • Dynamic hip screw
  • PFN
  • Trochanteric fracture

    1. 1. Trochanteric fracture Gopisankar.M.G. 2008 MBBS
    2. 2.  Occurs along a line between greater trochanter and lesser trochanter with variable comminution Totally extracapsular Four times more common than intracapsular
    3. 3.  Age  seen in elderly patients 10 – 12 years older than intracapsular # neck of femur Sex  f:m = 2.8 : 1
    4. 4. Clinical features Pain in the hip Marked shortening of the lower limb Complete external rotation deformity Swelling Echymosis Tenderness over the greater trochanter
    5. 5. X ray
    6. 6. Treatment Conservative  10% mortality Surgical
    7. 7. Conservative Indication1. Poor medical and surgical risk patients2. Terminally ill patients3. Very old patients Methods1. Simple support with pillows2. Buck’s traction3. Plaster spica4. Skeletal traction through distal femur or tibia for 10 – 12 weeks
    8. 8. Buck’s traction
    9. 9. Hip spica
    10. 10. Traction using Bohler Braunframe
    11. 11. Surgical 10 fold rise in mortality if surgery is delayed for > 48 hrs. Goal is to fix a stably reduced fracture internally
    12. 12. Methods of reduction Closed Reduction  traction , slight abduction and external rotation if cannot reduce  open reduction done Open Reduction  indications1. Failed closed reduction2. Large spike on proximal fragment with lesser trochanter intact3. Reverse oblique fracture Reduction Anatomically /non anatomically
    13. 13. Implants Dynamic Hip screw (DHS) Proximal Femoral nails (PFN)
    14. 14. Dynamic Hip Screws
    15. 15. Proximal Femoral Nails
    16. 16. Complications Malunion Coxa vara Traumatic Osteoarthritis

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