Intertrochanteric Hip Fractures Henderson NV
Las Vegas, NV
Desert Orthopaedic Center
Medical School: Harvard Med Sch, Boston Ma 02115
Graduation Year: 1993
Medical School: Univ Of Nv Sch Of Med, Reno Nv 89557
Graduation Year: 1983
Las Vegas, NV
Bone & Joint Specialists
Orthopedics, Degenerative Spinal Conditions
Cervical, Thoracic, and Lumbar Fusion
Cervical, Thoracic, and Lumbar Diskectomy
Cervical, Thoracic, and Lumbar Decompression
Total Disk Replacement - Cervical & Lumbar
Endoscopic Spinal Fusion
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes
Emergency Care: Yes
Primary Hospital: Valley Medical Center
Residency Training: Stanford University Hosptial & Clinics
Medical School: University Of Arizona College of Medicine, 1997
Member Organizations: North American Spine Society
American Academy of Orthopaedic Surgeons
American Medical Association
State Medical Society
State Orthopaedic Society
Awards: American Board of Orthopaedic Surgeons - Board Certified
Languages Spoken: English,Spanish,Chinese
Medical School: Creighton Univ Sch Of Med
Year of Graduation: 1990
Accepting New Patients: Yes
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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, ...