Trochanteric femur fracture: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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==Background== | ==Background== | ||
*Greater trochanter | *Greater trochanter | ||
** | **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 | ||
==Clinical Features== | ==Clinical Features== | ||
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*'''Lesser Trochanter''' | *'''Lesser Trochanter''' | ||
**Patients usually ambulatory | **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== | ||
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
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Evaluation
- 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