SEARCH RESULTS FOR: Subtrochanteric-Femur-Fracture

Subtrochanteric Femur Fracture

Subtrochanteric Femur Fracture: Pathogenesis and clinical findings High energy mechanism of fracture High energy trauma typically seen in younger patients (e.g. motor vehicle collision, fall from height) Strong lateral or axial force directed through femur Low energy mechanism of fracture Low energy trauma typically seen in elderly or patients with osteoporotic (e.g. falls) Atypical fractures Chronic bisphosphonate use (drug that inhibits osteoclasts from resorbing bone) Chronic suppression of bone resorption prevents natural bone building and breakdown (remodeling) Microscopic damage accumulates, weakening bone Pathologic fracture Primary or metastatic bone tumor Cancer cells in bone disrupt physiological bone remodeling Subtrochanteric Femur Fracture Fracture in the region of the femur that is 5 cm distal to lesser trochanter Muscle forces on proximal femur Muscle forces on distal femur Gracilis & adductor muscles exert shortening & adduction forces Gluteus medius & gluteus minimus muscles exert abduction force Iliopsoas muscles exert flexion forces Short external rotator muscles exert external rotation forces Bleeding from tissue & vascular damage Swelling & ecchymosis at fracture site Injury stimulates nerve fibres Displaced proximal femur Inability to weight bear Authors: Nojan Mannani Jack Fu Reviewers: Annalise Abbott Reza Ojaghi Usama Malik Michelle J. Chen Dr. Richard Buckley* Dr. Meredith Stadnyk* * MD at time of publication Shortened leg Hip & thigh pain Pain on motion Surgery is required to fix fracture. Complications may arise after operation. Femoral head & neck have limited blood supply which is required for fracture healing (union). Delay in surgery may ↑ time without supply Non-union of fracture Bone is unable to be aligned, leaving a space between broken bones Malunion of fracture (limb length discrepancy, rotation of limb) Surgical procedures ↑ risk of exposing incision to bacteria on contaminated instruments, skin, or in air Infection (acute or chronic) often associated with malunion Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Sept 24, 2017; updated Oct 14, 2024 on www.thecalgaryguide.com