Trochanteric

Etiology

• 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

Clinical features

• 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

Diagnostics

• 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)

Treatment [12]

• 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