Overview
Greater trochanter fractures involve the bony prominence of the femur where the gluteal muscles attach, often complicating conditions like greater trochanter pain syndrome (GTPS) characterized by gluteus medius and minimus tendon tears 1.Diagnosis
Clinical presentation includes pain over the lateral hip, exacerbated by activities like lying on the affected side 1.
Imaging: MRI is crucial for detailed assessment, identifying tears, bursitis, and fatty degeneration 1.
Classification: A 5-stage system based on intraoperative findings and MRI helps guide surgical intervention 1.Management
First-line treatments: Physical rehabilitation, activity modification, oral analgesics (e.g., NSAIDs), and peri-trochanteric injections (corticosteroids, PRP) 1.
Adjunctive treatments: Consider surgical intervention if symptoms persist despite conservative management 1.
- Endoscopic techniques include isolated bursectomy, tendon repair (single or double row), and muscle transfer 1.Special Populations
Pregnancy: Specific management strategies not detailed in provided abstracts 1.
Pediatrics: Not addressed in the given abstracts 1.
Elderly: Surgical risks and conservative management efficacy may vary; individualized treatment plans recommended 1.
Comorbidities: Management considerations for comorbidities not explicitly covered 1.Key Recommendations
Utilize MRI for accurate diagnosis and classification of gluteus medius and minimus tendon injuries (Evidence: Moderate) 1.
Initiate treatment with conservative measures including physical therapy, NSAIDs, and corticosteroid injections for gluteal pain 1.
Consider endoscopic surgical interventions for refractory cases, offering improved functional outcomes and lower complication rates compared to open surgery (Evidence: Moderate) 1.References
1 Thaunat M, Pacoret V, Saad M, Saint-Etienne A, Morvan A. Endoscopic treatment of gluteus medius tendon tear. Orthopaedics & traumatology, surgery & research : OTSR 2022. link