Intertrochanteric Hip Fractures Essex Junction VT

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Robert Danl Monsey, MD
(802) 656-4690
PO Box 1063
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1986

Data Provided By:
James Gregory Howe, MD
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Vt Coll Of Med, Burlington Vt 05405
Graduation Year: 1973

Data Provided By:
Tucker Andrew Drury
(802) 656-3806
95 Carrigan Dr
Burlington, VT
Specialty
Orthopedic Surgery

Data Provided By:
John F Lawlis
(802) 862-3983
6 San Remo Dr
South Burlington, VT
Specialty
Orthopedic Surgery

Data Provided By:
Seth West Frenzen
(802) 862-3983
6 San Remo Dr
South Burlington, VT
Specialty
Orthopedic Surgery

Data Provided By:
Paul Herbert Reiss, MD
28 Park Ave
Williston, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Case Western Reserve Univ Sch Of Med, Cleveland Oh 44106
Graduation Year: 1979

Data Provided By:
Claude Elmer Nichols, MD
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1979

Data Provided By:
Martin Hans Krag, MD
(802) 656-4472
95 Carrigan Dr Fl 4
Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Yale Univ Sch Of Med, New Haven Ct 06510
Graduation Year: 1975
Hospital
Hospital: Fletcher Allen Health Care, Burlington, Vt

Data Provided By:
Patrick Joseph Mahoney, MD
6 San Remo Dr
South Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Vt Coll Of Med, Burlington Vt 05405
Graduation Year: 1968

Data Provided By:
John F Lawlis III, MD
(802) 862-3983
6 San Remo Dr Ste 101
South Burlington, VT
Specialties
Orthopedics
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1982

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Best Treatment Choice for Intertrochanteric Hip Fractures

All intertrochanteric hip fractures are not alike. And because of that, each one must be evaluated and treated depending on the specific subtype of fracture present. The intertrochanteric region of the hip is just below the femoral neck. The femoral neck is the short column of bone between the main (long) shaft of the femur (thigh bone) and the round head at the top that fits into the hip socket.

About 40 per cent of all hip fractures in older adults are intertrochanteric fractures. A fall from a standing position is the most common mechanism of injury. But, of course, there are risk factors that lead to the fall -- older age, fragile or thin bones from osteoporosis, poor balance, and a previous history of falls. Women seem to be at greater risk for intertrochanteric fractures compared with men.

To repeat: all hip fractures and especially all intertrochanteric hip fractures are not alike and should not be treated in the same way each time. As the author of this article points out, the location and severity of the fracture are two defining characteristics that must be considered. A fracture high up near the femoral head is different from a fracture down lower (closer to the femoral shaft).

The failure rate of surgery to repair intertrochanteric hip fractures is high -- more than 50 per cent. One way to reduce this unacceptably high complication rate is to treat each and every intertrochanteric hip fracture according to its unique fracture pattern. The resulting anatomical and biomechanical changes must be reviewed and considered as well.

Stable fractures (those that are not displaced or separated and not likely to do so) can be treated with internal fixation . Fixation refers to the placement of metal plates, screws, pins, and/or wires to hold the broken pieces of bone together until they can heal. But fractures that extend up into the joint (called intracapsular ) may not respond as well. Total hip replacement may be the better choice for intertrochanteric fractures labeled as severe, unstable, and/or intracapsular. Hip replacement may also be preferred when the blood supply to the hip is compromised.

The surgeon is faced with quite a challenge when making the decision as to the "best" treatment. The goal is to relieve the patient's pain and keep him or her mobile (if they were mobile before the fracture). The first decision is whether to try and repair the fracture or replace the hip. Sometimes that decision is fairly evident. The patient's condition, activity level, and the severity of the fracture speak for themselves.

But more often, the surgeon must weigh the odds of the hip collapsing after repair, thus causing further pain, weakness, deformity, and difficulty standing and walking. The time between the fracture and surgery will also make a difference. Studies show the best results are linked with earlier surgery (within 24 hours of the fracture).

And surgeons must keep up with current studies and data. For example, ...

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