Intertrochanteric Hip Fractures Washington DC

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David C Johnson, MD
(202) 291-9266
106 Irving St NW
Washington, DC
Business
National Orthopedics PC
Specialties
Orthopedics

Data Provided By:
Edward G Alexander Jr., MD
(703) 461-7100
4801 Kenmore Ave
Alexandria, VA
Business
Northern Virginia Orthopaedic Group
Specialties
Orthopedics

Data Provided By:
Charles F Sanders, DDS
(202) 589-1360
Howard University School of Dentistry
Washington, DC
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Thesselon W Monderson, MD
(202) 865-1182
Washington, DC
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Randall Jeffrey Lewis, MD
(202) 466-5151
2021 K St NW Ste 400
Washington, DC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Harvard Med Sch, Boston Ma 02115
Graduation Year: 1969
Hospital
Hospital: George Washington Univ Hosp, Washington, Dc
Group Practice: Lewis Unger & Barth

Data Provided By:
James E Callan MD
(301) 891-6130
7610 Carroll Ave
Takoma Park, MD
Specialties
Orthopedics

Data Provided By:
Gregory Martin Ford, MD
(202) 898-5355
1810 5th St NW
Washington, DC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduation Year: 1980

Data Provided By:
John Anthony Boudreau, MD
(248) 914-0792
22 S Greene St,
Washington, DC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 2000

Data Provided By:
Julian Anthony Cameron, MD
Washington, DC
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Miami Sch Of Med, Miami Fl 33101
Graduation Year: 2000

Data Provided By:
St Elmo W Crawford, DDS
(202) 399-2244
1922 Benning Rd Ne
Washington, DC
Specialties
Orthodontics/Dentofacial Orthopedics

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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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