greater trochanter of femur

3 min read 15-03-2025

The greater trochanter is a bony prominence located on the proximal lateral aspect of the femur, the thigh bone. It plays a crucial role in hip stability and movement, serving as an attachment point for several important muscles. Understanding its anatomy, function, and potential issues is key to comprehending hip biomechanics and related pathologies.

Anatomy of the Greater Trochanter

The greater trochanter is a large, irregularly shaped bony projection. Its size and shape vary slightly between individuals. Its roughened surface provides ample area for muscle attachment. Key anatomical features include:

Superior border: This area forms the top of the trochanter.
Anterior surface: This faces forward toward the front of the thigh.
Medial surface: This faces inward towards the midline of the body.
Lateral surface: This faces outward toward the side of the thigh.
Posterior surface: This faces backward toward the back of the thigh.

Muscle Attachments

Several powerful muscles attach to the greater trochanter, contributing to hip movement and stability:

Gluteus medius: This muscle is a key abductor of the hip, meaning it moves the leg away from the midline of the body. Its attachment to the greater trochanter is crucial for maintaining pelvic stability during walking and other activities.
Gluteus minimus: Another hip abductor, working synergistically with the gluteus medius.
Piriformis: This muscle is involved in hip external rotation (turning the leg outwards) and abduction.
Obturator internus: Contributes to hip external rotation.
Obturator externus: Also contributes to hip external rotation.
Superior gemellus: Assists in hip external rotation.
Inferior gemellus: Assists in hip external rotation.
Gluteus maximus (indirectly): While not directly attached, the gluteus maximus's tendon blends with the iliotibial band, which interacts with the greater trochanter.

Function of the Greater Trochanter

The primary function of the greater trochanter is to provide a strong anchoring point for the muscles that move and stabilize the hip joint. This leverage is essential for activities requiring hip power, such as walking, running, jumping, and climbing stairs. Its strategic position also contributes to the overall biomechanics of gait. Damage or dysfunction affecting the greater trochanter can significantly impair mobility.

Greater Trochanter Pain Syndrome (GTPS)

Greater trochanter pain syndrome (GTPS) is a common cause of lateral hip pain. It's often characterized by pain over the greater trochanter, worsened by activities involving hip movement. While the exact cause isn't always clear, it's frequently associated with:

Bursitis: Inflammation of the bursa (fluid-filled sac) located over the greater trochanter, reducing friction between the muscle tendons and bone.
Tendinopathy: Degeneration or inflammation of the tendons attached to the greater trochanter, especially those of the gluteus medius and minimus.
Muscle strains or tears: Injury to the muscles surrounding the greater trochanter.
Referred pain: Pain originating from another area, such as the lower back, may be felt in the greater trochanter region.

Diagnosing GTPS

Diagnosis typically involves a physical examination assessing range of motion, tenderness to palpation, and muscle strength. Imaging studies such as X-rays or MRI scans may be used to rule out other conditions and confirm the diagnosis. A thorough evaluation is necessary to differentiate GTPS from other conditions such as hip osteoarthritis or lumbar radiculopathy.

Treating GTPS

Treatment for GTPS often focuses on conservative approaches:

Rest and activity modification: Avoiding activities that aggravate the pain is important.
Physical therapy: Exercises to strengthen hip abductor muscles, improve flexibility, and reduce inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce pain and inflammation.
Corticosteroid injections: Injections directly into the bursa or tendon to reduce inflammation.

Surgery is rarely needed for GTPS, usually only considered if conservative measures fail to provide relief.

Conclusion

The greater trochanter of the femur is a crucial anatomical structure vital for hip function and stability. Understanding its anatomy, function, and the potential for conditions like GTPS is essential for healthcare professionals and individuals alike. Early diagnosis and appropriate treatment can greatly improve outcomes and maintain mobility. If you experience persistent hip pain, consult a healthcare professional for accurate diagnosis and personalized treatment.