Difference between revisions of "Trochanteric femur fracture"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
Line 1: Line 1:
 
==Background==
 
==Background==
 
*Greater trochanter
 
*Greater trochanter
**caused by direct trauma (older patients) or avulsion injury (adolescents)
+
**Caused by direct trauma (older patients) or avulsion injury (adolescents)
 
*Lesser trochanter  
 
*Lesser trochanter  
**avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone
+
**Avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone
  
 
==Clinical Features==
 
==Clinical Features==
Line 10: Line 10:
 
*'''Lesser Trochanter'''
 
*'''Lesser Trochanter'''
 
**Patients usually ambulatory
 
**Patients usually ambulatory
**pain in groin worse with flexion
+
**Pain in groin worse with flexion, or patient has difficulty lifting leg at hip from seated position (iliopsoas insufficiency)
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==

Revision as of 22:22, 10 October 2018

Background

  • Greater trochanter
    • Caused by direct trauma (older patients) or avulsion injury (adolescents)
  • Lesser trochanter
    • Avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone

Clinical Features

  • Greater Trochanter
    • Hip pain that increases with abduction; tenderness over greater trochanter
  • Lesser Trochanter
    • Patients usually ambulatory
    • Pain in groin worse with flexion, or patient has difficulty lifting leg at hip from seated position (iliopsoas insufficiency)

Differential Diagnosis

Femur Fracture Types

Anterior view.
Posterior view.

Proximal

Shaft

Evaluation

Location of femur fractures
  • Consider AP pelvis in addition to AP/lateral views to compare contralateral side
  • Consider MRI if strong clinical suspicion but negative x-ray

Management

  • Treatment for both types:
    • Non-weight bearing with ortho follow up in 1-2wk

Disposition

  • Outpatient

See Also

External Links

References