Intertrokanteriska

Intertrokanteriska refers to the intertrochanteric region of the proximal femur, the area between the greater trochanter and the lesser trochanter. This region is a key anatomical zone because it bears significant mechanical loads and serves as an attachment site for hip muscles.

Clinical significance: The intertrochanteric area is a common site for fractures, particularly in older adults with osteoporosis or after low-energy falls. Intertrochanteric fractures are typically extracapsular and can be classified as stable or unstable based on fracture pattern and comminution. Complications may include malunion, nonunion, and impaired mobility.

Diagnosis and imaging: Acute hip pain with leg shortening and external rotation suggests a fracture. Evaluation includes radiographs of the pelvis and hip (anteroposterior and lateral views). In complex or atypical cases, CT or MRI may be used to delineate fracture lines and plan fixation.

Treatment: Most intertrochanteric fractures require surgical fixation to allow early mobilization. Preferred methods include intramedullary cephalomedullary nails or extramedullary sliding hip screws, with choice guided by fracture stability, bone quality, and surgeon preference. Nonoperative treatment is rarely indicated in medically fit patients.

Prognosis and prevention: Mortality and morbidity after hip fractures remain elevated in the elderly. Early surgery, optimized medical management, and rehabilitation improve outcomes. Preventive measures focus on osteoporosis treatment, nutrition, balance training, and fall prevention.