In 1961, Gordon stated that trochanteric bursitis started in the gluteus tendons at their attachment to the
greater trochanter. (11) Gordon thought adjacent bursae were involved secondarily, analogous to bursitis and tendinitis of the shoulder.
Previous to dissection of gluteal region, the sacrum, ischial tuberosity and
greater trochanter of the femur were used as landmarks to make an incision and get rid of the skin and subcutaneous tissue.
After relocating the hip and closing the capsule, the
greater trochanter was reattached using 2 cannulated 6.5 mm screws (Figure 5).
Entry point is made with bone awl over a tissue protector at the tip of
greater trochanter in antero-posterior view and midpoint of
greater trochanter in lateral view.
After reduction, on the lateral side of the affected lower limb, a 2.5 mm Kirschner wire was inserted percutaneously to serve as a guiding wire toward the femoral head under fluoroscopic visualization, which was 5-6 cm distal from the
greater trochanter. The guiding wire crossed femoral neck and femoral calcar, and stopped at 0.5-1.0 cm under the joint surface of the femoral head.
Length of the femur, distance between the nutrient foramina and the superior border of the
greater trochanter and lateromedial diameters and anteroposterior of the femur at the level of the diaphyseal nutrient foramina, in 50 bones of adults subjects, of both sexes from the Museum of Anatomy of the Faculty of Medicine of the Universidad de La Frontera, Chile.
Skin incision made 4 to 5cm above
greater trochanter, adequate enough to make entry point.
The growth areas in the proximal femur are the physeal plate, the growth plate of the
greater trochanter, and the femoral neck isthmus.
It was found to be present about 7 cm below the tip of the
greater trochanter (Figure--1) and on careful measurement with a measuring tape, the bony projection was found to be about 1.70 cm in length (Figure--2).
The morphological appearance of hips that have sustained an insult during growth is frequently characterized by a deformed epiphysis, a short femoral neck, and a
greater trochanter with a tip that is higher than the center of the femoral head.
The bone substance of the
greater trochanter, femoral neck, and femoral trochanter was poor and showed bone fragility.
If open reduction of the fracture becomes necessary and several fragments are found (especially of the
greater trochanter), a dynamic hip screw (DHS) with the trochanter stabilizing plate is preferred.