Overview
An intertrochanteric hip fracture is a break in the upper part of the thigh bone (femur) between the greater and lesser trochanters near the hip joint. It often happens after a fall and can disrupt the way the hip carries body weight, which leads to significant pain and difficulty moving. Swelling and bleeding around the fracture can also make the hip feel stiff and tender. Because the bone is weakened, patients may have weakness and reduced ability to stand or walk without support.
Symptoms
Most people have pain in the hip or groin area after a fall or twisting injury, and the pain usually becomes worse with standing or trying to bear weight. You may notice trouble lifting the leg, reduced hip range of motion, and difficulty getting comfortable in bed. Some patients develop bruising and swelling around the hip, and in more severe cases the leg may look shorter or rotated compared with the other side. Weakness can make it hard to get up from a chair, use stairs, or even take a few steps.
Causes
Intertrochanteric hip fractures are most commonly caused by trauma, especially a fall in older adults. In some cases, weakened bone from osteoporosis or other bone conditions allows a low-impact fall to fracture the femur. The fracture line disrupts stability in the weight-bearing portion of the hip, and healing can be complicated if the bone keeps moving during the early weeks.
Risk Factors
Risk increases with age because falls become more common and bone density often decreases over time. Osteoporosis, previous fractures, and long-term steroid use can weaken bone and make fractures more likely. Muscle weakness, balance problems, poor vision, and medications that cause dizziness or sedation raise the chance of falling. Certain medical conditions that affect walking and coordination, along with alcohol use, also increase risk.
Prevention
You can reduce risk by focusing on fall prevention, including improving balance and strength through guided exercise and checking your home for trip hazards. Addressing bone health with osteoporosis evaluation and treatment, along with adequate calcium and vitamin D intake when appropriate, can lower fracture risk. Regular vision and hearing checks, reviewing medications for dizziness, and using assistive devices when needed can further reduce the chance of a fall. Staying active within safe limits helps maintain the strength needed to protect the hips during everyday movement.
How the Diagnosis Is Evaluated
Clinicians start with a history of the fall or injury and assess symptoms such as inability to bear weight and hip pain. A focused physical exam looks for deformity, leg length differences, pain with hip movement, and nearby bruising or swelling. X-rays of the pelvis and affected hip are the main test to confirm the fracture, and additional imaging such as CT may be used if the fracture type is unclear or if symptoms are severe but the X-ray is not definitive. Not every test is needed for every patient, and the evaluation is tailored to stability and overall health.
Nonsurgical Treatment Options
Non-surgical treatment is sometimes considered for carefully selected, stable, or non-displaced fractures, or when surgery is not an option due to medical risk. Care typically includes strong pain control, usually with acetaminophen and carefully selected medications prescribed by a clinician. Patients are often placed on protected or limited weight-bearing with a walker or crutches, and they may require close follow-up with repeat imaging to confirm the fracture is healing in the correct position. Physical therapy is used to maintain mobility, prevent complications like deconditioning and stiffness, and improve safe walking and transfers. Medical management may also include fall-prevention planning, treatment of bone health, and preventive measures against complications such as blood clots.
When to Seek Medical Attention
Seek emergency or urgent medical care if you have severe hip or groin pain after a fall, cannot bear weight, or notice deformity such as shortening or abnormal rotation of the leg. Get prompt evaluation if you develop rapidly increasing swelling or bruising, new numbness or weakness in the leg, or symptoms that are worsening rather than improving. Call for urgent help immediately if you have fever, feel unwell with worsening pain, or develop signs concerning for a blood clot such as new calf swelling or sudden shortness of breath.
Frequently Asked Questions
In some cases, stable or non-displaced fractures and patients who cannot safely undergo surgery may be managed without surgery, but this requires close orthopedic follow-up and often repeat X-rays.
Healing often takes weeks to months, and recovery speed depends on fracture stability, age, bone health, and how early and safely you can begin rehabilitation.
Next Steps
If you suspect an intertrochanteric hip fracture, arrange prompt medical evaluation, especially if you cannot bear weight or the hip looks deformed. Ask an orthopedic clinician about whether your fracture pattern is stable enough for conservative care and what weight-bearing restrictions and follow-up imaging are needed. Plan for early physical therapy and fall-prevention steps to support safer recovery.