Difference between revisions of "Trochanteric femur fracture"

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*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
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 +
{{Femur fracture types}}
  
 
==Clinical Features==
 
==Clinical Features==
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==Differential Diagnosis==
 
==Differential Diagnosis==
{{Femur fracture types}}
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{{Hip pain DDX}}
  
 
==Evaluation==
 
==Evaluation==
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===Specific Managment===
 
===Specific Managment===
*Treatment for both types:
 
**Non-weight bearing with ortho follow up in 1-2wk
 
  
 
==Disposition==
 
==Disposition==
 
*Outpatient
 
*Outpatient
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**Non-weight bearing with ortho follow up in 1-2 weeks (for both types)
  
 
==See Also==
 
==See Also==

Latest revision as of 19:40, 22 October 2020

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

Femur Fracture Types

Anterior view.
Posterior view.

Proximal

Shaft

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

Hip pain

Acute Trauma

Chronic/Atraumatic

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

General Fracture Management

Specific Managment

Disposition

  • Outpatient
    • Non-weight bearing with ortho follow up in 1-2 weeks (for both types)

See Also

External Links

References