Intertrochanteric Hip Fractures

hip fracture

An intertrochanteric hip fracture is a specific type of broken hip.  While the words "hip fracture" are used to describe a variety of fracture patterns, most hip fractures can be grouped into a few specific types. 

An intertrochanteric fracture occurs lower in the thigh bone (femur) than a femoral neck fracture.  While a femoral neck fracture occurs when the ball is broken off the top of the thigh bone, the intertrochanteric fractures occur further down the bone.

  Intertrochanteric hip fractures are treated very differently because they do not have the issues with damage to blood flow to bone seen with the femoral neck fractures. Because the blood supply to the bone is not typically damaged, these fractures can be repaired, and do not require a hip replacement procedure.

The trochanter of the femur is the location of the attachment of large tendons to the bones.  There are two trochanters (greater and lesser) where some of the large tendons of hip muscles attach to the thigh bone.  An intertrochanteric fracture extends from one trochanter, across the femur, and through the other trochanter. 

Treatment of Intertrochanteric Fractures

Intertrochanteric fractures are usually surgically repaired. During the surgery, the fractured bone is realigned, and then held in proper position with metal implants.  Some surgeons use a metal plate and screws, while other surgeons may use a metal rod and screws.


Surgery is typically performed under a a general or spinal anesthesia in the operating room. Patients with an intertrochanteric fracture are 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.  Alternatively, your surgeon may place a metal rod down the hollow center of the bone, and then hold the metal rod in position with screws inserted through the rod both above and below the fractured bone.  Throughout the procedure, your surgeon will use x-ray to confirm the position of the implants and ensure the fracture is well aligned.  Both types of fracture fixation (the plate and the rod) have shown good healing and have had excellent results.

Rehab After Intertrochanteric Fractures

Patients who sustain an intertrochanteric fracture 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 on the broken extremity 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.

Subtrochanteric Fractures

As stated earlier, the words hip fracture can be used to describe many fracture patterns, and there are some less common fracture patterns that have specific treatment implications.  One group of fractures similar to an intertrochanteric fracture is called a subtrochanteric femur fractures.  These fractures are also at the top of the thigh bone (femur), but extend lower into the shaft of the thigh bone and require more extensive surgical support to hold the fracture in position.  Subtrochanteric femur fractures may require more significant restrictions with rehab and therapy as well.


KJ Koval and JD Zuckerman; "Hip Fractures: II. Evaluation and Treatment of Intertrochanteric Fractures" J. Am. Acad. Ortho. Surg., May 1994; 2: 150 - 156.

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