Difference between revisions of "Trochanteric femur fracture"

(Diagnosis)
 
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==Background==
 
==Background==
 +
*Greater trochanter
 +
**Caused by direct trauma (older patients) or avulsion injury (adolescents)
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*Lesser trochanter
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**Avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone
 +
 +
{{Femur fracture types}}
  
 
==Clinical Features==
 
==Clinical Features==
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*'''Greater Trochanter'''
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**[[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==
 
==Differential Diagnosis==
{{Femur fracture types}}
+
{{Hip pain DDX}}
  
==Diagnosis==
+
==Evaluation==
 
{{Proximal femur fracture diagnosis}}
 
{{Proximal femur fracture diagnosis}}
  
 
==Management==
 
==Management==
 +
{{General Fracture Management}}
 +
 +
===Specific Managment===
  
 
==Disposition==
 
==Disposition==
 +
*Outpatient
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**Non-weight bearing with ortho follow up in 1-2 weeks (for both types)
  
 
==See Also==
 
==See Also==
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*[[Femur fracture]]
  
 
==External Links==
 
==External Links==
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<references/>
 
<references/>
  
===Trochanteric===
+
[[Category:Orthopedics]]
*'''Greater Trochanter'''
 
**Via direct trauma (older pts) or avulsion injury (adolescents)
 
** Hip pain that increases with abduction; tenderness over greater trochanter
 
*'''Lesser Trochanter'''
 
**Via avulsion due to forceful contraction of iliopsoas (adolescents) or pathologic bone
 
**Pts are usually ambulatory; c/o pain in groin worse w/ flexion
 
*Treatment for both types:
 
**NWB with ortho f/u in 1-2wk
 

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