An Overview of Management Options of Unstable Intertrochanteric Fractures

Abstract

Background: Fractures of the Intertrochanteric (IT) region are some of the most common
fractures encountered by an orthopaedic surgeon. The incidence of these fractures is also
increasing with increase in life expectancy. There is an increased incidence of hip
fractures with aging due to a decrease in muscle mass around the hip and osteoporosis
and is becoming more common as the proportion of elderly people in the population
increases, by 2040 the incidence is expected to have doubled. IT fractures account for
approximately 45% to 50% of all hip fractures in the elderly and out of these, 50% to
60% are classified as unstable .The incidence of failure with unstable IT fractures is as
high as 50% and the cut-out rate can be as high as 8% for D.H.S. The goal of treatment is
restoring mobility safely and efficiently, while minimizing the risk of medical
complications and technical failure. Restoration of mobility depends on the quality of
bone and the type of implant used. Treatment with primary bipolar arthroplasty could
perhaps return these patients to their preinjury level of activity more quickly, thus
obviating the postoperative complications caused by immobilization or failure of the
implant