Trochanteric femur fracture

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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

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