Femur fractures, such as intertrochanteric fractures, generally cross in the area between the lesser trochanter and the greater trochanter. Fractures that occur between the neck of the femur and a lower bony prominence are called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.
Most intertrochanteric fractures are managed with either an intramedullary nailing or compression hip screws. Intramedullary nailing involves insertion of a specially designed metal rod (intramedullary rod) into the marrow canal of the femur through an opening made at the top of the greater trochanter. Intramedullary rods are used to align and stabilize fractures. A lag screw is then placed through the nail and up into the neck and head of the hip. As with the compression hip screw, sliding of the lag screw and impaction of the fracture take place.