Diagnosis Name: Since the patient has reported of severe pain on the right hip and upper thigh, it is likely it is a hip fracture known as an intertrochanteric fracture.
Explanation: The location of this structure is between the lesser trochanter and the greater trochanter of the femur ( Chotai et al . 2015). Also, the x-ray image shows the disconnected parts of the proximal femur which include the trochanteric region, femoral neck, and head. The fracture has occurred where the gluteus minimus and gluteus medius attach.
Delegate your assignment to our experts and they will do the rest.
Causes/Risk Factors: Risk factors include anything has the possibility of increasing occurrence of inter-trochanteric fracture ( Vimal Kumar et al . 2018). Osteoporosis is the common cause while age is the major risk factor for hip fracture. Further, the patient is Caucasian and sedentary.
Other risk factors although not limited to this list include:
Excessive caffeine or alcohol consumption
Low body weight
Dementia
Cigarette smoking
Tall stature
Clinical Manifestation: As shown on X-ray, osteoporotic femur differs from the normal femur. First, osteoporosis may be signaled by a decreased bone volume and also when the loss of compact bone is less than the loss of spongy bone ( Lin and Wang, 2016) . Some of the notable osteoporotic changes in the femur are that the outer layer of the compact bone may start shrinking.
Diagnostic Procedures: Wolff’s law is another diagnostic procedure applicable in the case of Margaret. The hypothesis of the law emphasis on the effect of bone remodeling using weight-bearing. According to Wolff’s law, the ability of the bone to remodel and grow depends on the placed mechanical stresses. In other words, it depends on muscle pull. The presumption for this is that large bony are processed where muscles attach to or pull on bone.
Treatment: Margaret may be placed under three forms of medication which include (A) oral estrogen, (B) oral calcium supplementation, and (C) oral alendronate sodium (Fosamax).
The presence of estrogen in the body helps in stimulating osteoblasts which form new bones.
Calcium is one of the major raw materials for bone formation.
It inhibits the capacity of the bones to resorb osteoclasts.
References
Chotai, P. N., Ebraheim, N. A., Hart, R., & Wassef, A. (2015). Concomitant posterior hip dislocation, ipsilateral intertrochanteric-and proximal tibial-fractures with popliteal artery injury: a challenging trauma mélange. Clinics and practice , 5 (4).
Lin, W., Ye, J., Zou, Z., Wu, F., Wang, H., Ou, R., & Bai, B. (2016). Risk factors for failed internal fixation in surgery of senile femoral intertrochanteric fractures. Chinese Journal of Orthopaedic Trauma , 18 (7), 625-629.
Vimal Kumar, K. H., Arunkamal, C., Devendra, A., Ramesh, P., & Dheenadayalan, J. (2018). Comparison of radiological outcome of unstable Intertrochanteric femur fractures in elderly patients treated with Indian and Foreign Cephalomedullary nails. International Journal of Orthopaedics , 4 (1), 296-302.
Xue, D., Yu, J., Zheng, Q., Feng, G., Li, W., Pan, Z., ... & Li, H. (2017). The treatment strategies of intertrochanteric fractures nonunion: An experience of 23 nonunion patients. Injury , 48 (3), 708-714.
