PATHOPHYSIOLOGY OF INTERTROCHANTERIC FRACTURE

PREDISPOSING FACTORS

 Age: 90 years old

 Race: (Filipino) Asians PRECIPITATING FACTORS
 Sex: Female
 Recurrent falls

Trauma caused by fall  Poor gait

Bone breakage Disruption / compression of nerve endings

osteonecrosis
↑ nociception

soft tissues injury, bleeding ↑ vital signs, Pain

typically occurs around scale of 6/10
site and into the soft
tissues surrounding the
bone.
Acute pain
Osteoblastic activity is
immediately stimulated, both Release of cytokine cells (IL-1, TNF-
intraosseous and periosteal α, etc.), prostaglandins, bradykinin
from osteoprogenitor cell and reactive oxygen species (ROS)

Vasodilation Swelling on
surrounding site of
Warm injury
and flushed
skin overlying the
fracture site
 ↑ blood flow to the area
of injury

Leukocytes and mast cells accumulate

Lab result: ↑ WBC; ↑
Neutrophils
Phagocytosis and removal
of dead cell debris

A fibrin clot (fracture hematoma) forms at the Lab result: ↓ RBC and
break and acts as a new network to which Hgb;
cells can adhere Hematoma around site of
injury

Disruption in fracture hematoma due

to minimally displaced fracture along
the base of the left femoral neck
extending to the left lesser trochanter

Maintenance of
immobilization to facilitate
bone healing

Decreased or limited
ROM and Muscle
strength

Prolonged immobilization

Impaired physical mobility

 Risk for peripheral
neurovascular dysfunction