Describe the etiology and clinical features.
Greater trochanteric fracture
Avulsion of the greater trochanter apophysis due to forceful contraction of the gluteus medius and minimus muscles (typically during physical activity)
Direct trauma to the greater trochanter (e.g., due to a fall onto the hip)
Lesser trochanteric fracture
Avulsion of the lesser trochanter apophysis due to forceful contraction of the iliopsoas muscle
Most commonly seen in physically active young adults, particularly those who participate in high-impact sports such as wrestling
Greater trochanteric fracture: local pain exacerbated by abduction
Lesser trochanteric fracture: groin pain, which radiates to the knee or posterior thigh and worsens with hip flexion and rotation
Describe diagnostics and treatment.
X-ray showing avulsion of the greater or lesser trochanter
MRI if a pathological fracture is suspected or in individuals at risk of fracture extension (e.g., patients with osteoporosis)
Typically self-limiting and conservative treatment suffices (e.g., no weight-bearing on the affected leg, ice, and physical therapy).
Surgical repair in fractures with displacement > 1 cm