The fracture of the intertrochanteric femur is usually treated by osteosynthesis, an intervention using nails and screws to attach the bones. Hip fractures are very common among the elderly, mainly because of osteoporosis. Accordingly, the fracture of the upper end of the femur occurs after trauma, usually a fall to the ground. The affected area may be the neck of the femur or the "trochanteric mass" located below the neck of the femur. The pain is immediate, and walking could become impossible.
The diagnosis is confirmed on the x-ray of the pelvis and hip which shows the fracture and its location. After the diagnosis, if possible, the ideal treatment is to keep the hip with osteosynthesis and not to replace it.
The hip nailing procedure
The hip nailing intervention can be performed both under general or local anesthesia. The fracture is stabilized with a large nail and screws. If needed, the surgeon may also use plates to attach the bones. The affected area heals on its own over time. Normally, the patient has to be hospitalized for a period of two to four days.
After having undergone this intervention, the support can be authorized depending on the stability of the osteosynthesis and the bone quality of the patient. Generally, the patient will be able to resume walking as soon as they return home. If the result is not acceptable there might be a need for hip replacement surgery which the worn-out hip joint or bone fragments with a hip prosthesis (implant).
Getting up and resting on the limb are generally authorized the same day or the next day. The rehabilitation of the hip is mainly by the recovery of walking. Certain specific movements should be avoided to prevent the risk of dislocation. The patient would need rehabilitation either at home with a physiotherapist or in a rehabilitation center and that there would be serval postoperative checkups with the surgeon. Walking is possible with the help of crutches or by a walker until the balance is restored.