Isolated fracture of the lesser trochanter in adults

Abstract. In adults, an isolated non-traumatic fracture of the lesser trochanter should arouse strong suspicion of an underlying malignant pathology. In this article, we present the case of a 55-year-old male patient who presented with a non-traumatic isolated fracture of the lesser trochanter secondary to a delayed diagnosis of metastases of bronchial carcinoma.

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A Case of Isolated Fracture of the Lesser Trochanter

Acta Orthopaedica Scandinavica ◽

10.3109/17453673208991229 ◽

1932 ◽

Vol 2 (1-4) ◽

pp. 160-165 ◽

Cited By ~ 3

Author(s):

Ynqve Kewenter

Keyword(s):

Lesser Trochanter ◽

Isolated Fracture

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Isolated Fracture of the Lesser Trochanter as a First Manifestation of Metastatic Lung Carcinoma

Journal of Medical Cases ◽

10.4021/jmc1077w ◽

2013 ◽

Author(s):

Reategui-Villegas

Keyword(s):

Lung Carcinoma ◽

Lesser Trochanter ◽

Isolated Fracture ◽

Metastatic Lung ◽

Metastatic Lung Carcinoma

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Hip geometry in hip fracture patients in Greenland occurring over a 7.7-year period

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02482-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Inuuteq Fleischer ◽

Mogens Laursen ◽

Stig Andersen

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Fracture Risk ◽

Cortical Thickness ◽

Geometric Analysis ◽

Osteoporotic Fractures ◽

Premature Death ◽

Neck Length ◽

Hip Geometry ◽

Lesser Trochanter

Abstract Background Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. Methods We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. Results We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). Conclusion Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.

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A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0041-1728760 ◽

2021 ◽

Author(s):

Andrew G. Yun ◽

Marilena Qutami ◽

Kory B. Dylan Pasko

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Radiation Exposure ◽

Hip Arthroplasty ◽

Fluoroscopy Time ◽

Lesser Trochanter ◽

Total Hip ◽

Preoperative Templating ◽

The Mean ◽

Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

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