Trochanteric femur fracture

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

Differential Diagnosis

Femur fractures

Proximal

• Intracapsular
  • Femoral head fracture
  • Femoral neck fracture
• Extracapsular
  • Intertrochanteric femur fracture
  • Trochanteric femur fracture

Shaft

• Mid-shaft femur fracture (all subtrochanteric)

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

• Femur fracture

References

Authors

Ross Donaldson, Claire, Neil Young, Daniel Ostermayer