Intertrochanteric fracture and the unexpected recovery of a 76-year-old male patient

Recently, Dr. Vu Anh received a case of a 76-year-old elderly man with an intertrochanteric femur fracture. This is a common type of fracture in the elderly, especially when bone quality has declined due to osteoporosis. If not treated promptly, patients must endure prolonged immobilization, facing many dangerous complications such as pneumonia, pressure ulcers, deep vein thrombosis, or impaired motor function.

Although the situation was quite urgent, the family still managed to consult multiple medical facilities in time. Some places advised a hip replacement, while others recommended osteosynthesis using various methods. After thorough research and consideration, the family decided to put their trust in me and chose the closed reduction and internal fixation method using a PFNA nail.

PFNA (Proximal Femoral Nail Antirotation) is currently one of the most effective treatments for intertrochanteric and subtrochanteric femoral fractures in the elderly. The advantages of this technique include fracture reduction under C-arm fluoroscopy, a very small incision, minimal invasiveness, rigid bone fixation, and enabling early mobilization after surgery.

In particular, the postoperative course is usually very 'smooth', intraoperative blood loss is minimal, significantly reducing the risk of complications in elderly patients with multiple comorbidities. With a small skin incision, patients experience less postoperative pain and a more favorable functional recovery.

Figure 1: Postoperative radiograph: PFNA nail for the intertrochanteric fracture

Figure 2: Minimally invasive nail insertion incision

And what made both the family and my team the happiest was the elderly gentleman's recovery rate. Just one day after surgery, the patient was almost pain-free, had good hip range of motion, and was able to practice standing and walking with a walking frame under the guidance of medical staff. For many families, this is very hard to imagine when they had just witnessed their loved one suffer a bone fracture only a few days prior.

Figure 3: Male patient practicing walking 1 day after surgery

When I came for postoperative rounds, the patient's daughter expressed her sincere gratitude and presented a small gift bag. Inside was a pomelo and a heartfelt letter. As always, I only accepted the pomelo.

Every successful surgery is a joy. And the smiles, handshakes, or words of gratitude from patients and their families are what make the medical profession truly special.