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  3. Diagnosis
  4. Indications
  5. Treatment

Authors of section


Theerachai Apivatthakakul, Jong-Keon Oh

Executive Editor

Michael Baumgaertner

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Nonoperative treatment

1. Treatment principles

Nonoperative treatment is reserved for medically infirm patients that cannot tolerate any surgical intervention.

Initial treatment is symptomatic with bed rest and pain management.

Patients with intracapsular fractures generally tolerate mobilization before patients with extracapsular fractures.

Therefore, skin traction may be appropriate for intracapsular fractures, but most patients with trochanteric fractures will benefit from at least 2 weeks of skeletal traction before any attempt to mobilize from bed to chair.

2. Skin traction

Skin traction may be used for pain relief but only for a few days maximum due to the likelihood of the adhesive wrap compromising the integrity of the skin.

Use about 2 kg of weight over the end of the bed for traction.

Straight skin traction with weight over the end of the bed

3. Mobilization

Mobilization starts when pain is tolerable; the patient may weight bear as tolerated with walking aids.

Patient mobilization with weight bearing as tolerated and walking aids after nonoperative treatment of proximal femoral fractures