Hip Fracture

Surgical management of the intertrochanteric fracture requires a sliding hip screw. This consists of a plate and barrel firmly fixed to the proximal femur with a large lag screw that enters into the femoral head and is connected to the plate through the barrel. The fracture site is compressed, as the screw is able to collapse inside the barrel, and compression of osteoporotic bone at the fracture site affords increased stability and enhances bone union. If there is comminution (multiple bone fragments) at the posteromedial aspect of the proximal femur, the fixation can be unstable and may reduce the patient's ability to walk after surgery until bone union occurs (see Figure 3).