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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Fractures of the Lesser and Greater Trochanter



- Lesser Trochanteric Fracture:
    - isolated fracture of the lesser trochanter is quite rare but may develop as a result of the avulsion force if the iliopsoas muscle;
    - it occurs commonly as a component of intertrochanteric fracture;
    - frx of the lesser trochanter along with a subtroch or intertroch fracture is by definition unstable;
- Greater Trochanteric Fracture:
    - isolated fracture of the greater trochanter may be caused by direct injury or may occur indirectly as a result of the activity of gluteus 
         medius and gluteus minimus muscles;
    - it occurs most commonly as a component of intertrochanteric fractures;
    - if displacement is less than 1 cm and there is no tendency to further displacement (determined by repeated x-ray examinations), 
         treatment may be by bedrest w/ affected extremity in balanced suspension until the acute pain subsides;
    - as rapidly as symptoms permit, activity can increase gradually to protected wt bearing with crutches;
    - full wt bearing is permitted as soon as healing is apparent, usually in 6 to 8 weeks;
    - if displacement is greater than 1 cm and increases on adduction of thigh, extensive tearing of surrounding soft tissues may be assumed




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, September 9, 2011 11:37 am