Greater trochanter fracture: Definition, Uses, and Clinical Overview

Posted on February 27, 2026 | by drhip

Greater trochanter fracture Introduction (What it is)

A Greater trochanter fracture is a break in the bony prominence on the outside of the upper femur (thighbone).
The greater trochanter is where important hip muscles attach, so injury can affect walking and side-hip strength.
This term is commonly used in orthopedics, emergency care, sports medicine, and radiology when evaluating hip pain after a fall or trauma.
It can occur by itself or alongside other hip-region fractures that may be less obvious on initial imaging.

Why Greater trochanter fracture used (Purpose / benefits)

“Greater trochanter fracture” is a diagnostic label clinicians use to describe a specific location and pattern of hip injury. Naming the injury precisely matters because the greater trochanter is a key attachment site for the hip abductor muscles (muscles that move the leg out to the side and stabilize the pelvis when you stand on one leg).

In practice, identifying a Greater trochanter fracture helps clinicians:

Localize the source of pain to a specific bony structure rather than attributing symptoms only to “hip strain” or “bursitis.”
Estimate stability and risk by determining whether the fracture is isolated (limited to the greater trochanter) or whether it extends into the intertrochanteric region (between the greater and lesser trochanters), which can change management.
Plan appropriate imaging when plain X-rays do not fully explain pain, bruising, or difficulty bearing weight.
Guide treatment selection (often nonoperative care for stable, minimally displaced fractures; surgical options may be considered when displacement, instability, or functional deficits are concerns—varies by clinician and case).
Set expectations for recovery in general terms, since bone healing and muscle function recovery can differ from soft-tissue-only conditions.

Indications (When orthopedic clinicians use it)

Orthopedic clinicians and related healthcare teams typically consider the diagnosis of a Greater trochanter fracture in scenarios such as:

Hip or outer-thigh pain after a fall, especially in older adults
Pain and tenderness directly over the lateral hip (outside of the hip)
Difficulty walking or a new limp after trauma
Suspected avulsion-type injury (a fragment pulled by tendon/muscle) in athletes after sudden forceful contraction
Persistent symptoms with normal or unclear X-rays, prompting consideration of MRI or CT to evaluate occult fracture extension
Hip pain after hip arthroplasty (hip replacement) where a periprosthetic greater trochanter fracture is part of the differential diagnosis (varies by implant design and case)

Contraindications / when it’s NOT ideal

A Greater trochanter fracture is a diagnosis rather than a treatment, so “contraindications” apply most practically to when it’s not appropriate to assume the injury is isolated or low risk, or when a different diagnostic or management approach may be more suitable.

Situations where it may be not ideal to treat it as a simple isolated fracture (and where additional evaluation or another approach may be considered) include:

Concern for fracture extension into the intertrochanteric region (may require different management—varies by clinician and case)
Inability to bear weight or pain out of proportion to a small-appearing fracture on X-ray (may indicate an occult component)
Marked displacement of the trochanter fragment that could affect abductor function (thresholds vary by clinician and case)
Associated injuries (femoral neck fracture, pelvic fracture, acetabular injury) that change priorities and treatment planning
Open fracture (skin wound communicating with fracture) or suspected infection, which requires urgent specialty evaluation
Complex postoperative scenarios after hip surgery, where implant type, fixation quality, and bone health influence decisions (varies by material and manufacturer, and by case)
Medical factors (bone fragility, bleeding risk, severe medical instability) that may influence whether surgical options are feasible—varies by clinician and case

How it works (Mechanism / physiology)

A fracture is a structural failure of bone. For a Greater trochanter fracture, the biomechanics and symptoms relate to the location and the muscle attachments at the greater trochanter.

Mechanism and forces involved

Common mechanisms include:

Direct impact to the lateral hip (for example, falling onto the side)
Twisting or rotational forces transmitted through the upper femur during a fall
Avulsion mechanism, where strong muscle contraction pulls on the tendon attachment and removes a small piece of bone (more often discussed in younger or athletic populations, though patterns vary)

Relevant hip anatomy (what structures are involved)

Key structures around the greater trochanter include:

Femur (thighbone): the greater trochanter is the large lateral prominence at the top of the femur.
Hip abductor muscles:
Gluteus medius and gluteus minimus attach near the greater trochanter and help stabilize the pelvis during walking.
Injury can lead to pain with single-leg stance and a limp due to abductor weakness or pain inhibition.
Iliotibial band (IT band): runs along the outside of the thigh and passes over the greater trochanter region.
Trochanteric bursae: small fluid-filled sacs that reduce friction between tendons and bone; swelling here can coexist with fracture-related inflammation.
Intertrochanteric region: the area between greater and lesser trochanters; some fractures that appear isolated may have subtle extension into this region, which can alter stability assessment.

Onset, duration, and reversibility (as applicable)

Onset: Symptoms typically begin immediately after injury, with localized pain and tenderness. Bruising and swelling may develop over hours to days.
Duration: Bone healing occurs over weeks to months, but timelines vary by age, bone quality, displacement, and overall health. Functional recovery may lag behind pain improvement due to abductor deconditioning.
Reversibility: The fracture itself heals by bone repair processes; persistent symptoms may relate to associated soft-tissue injury, altered gait, or (less commonly) healing complications. Exact outcomes vary by clinician and case.

Greater trochanter fracture Procedure overview (How it’s applied)

A Greater trochanter fracture is not a single procedure; it is a clinical diagnosis that leads to a structured evaluation and, when needed, a management plan. A typical high-level workflow looks like this:

Evaluation and exam – History of injury mechanism (fall, direct impact, sports event) – Location of pain (outer hip vs groin vs buttock) – Ability to bear weight and gait observation (as tolerated) – Examination for tenderness over the greater trochanter and assessment for other injuries
Initial imaging – Plain X-rays of the hip/femur are commonly used first to look for a visible fracture and to screen for other fracture patterns.
Additional testing when needed – MRI or CT may be used when clinicians suspect an occult extension, need more detail on fracture configuration, or must evaluate surrounding soft tissues. Selection varies by clinician and case.
Management selection – Nonoperative pathways may be considered for stable, minimally displaced patterns, often emphasizing symptom control and progressive function (specific restrictions vary by clinician and case). – Operative pathways may be considered for displacement, instability, functional compromise of the abductors, or complex patterns (fixation method varies by surgeon preference and case).
Immediate checks – Reassessment of pain, mobility, and neurovascular status of the limb (circulation and nerve function) – Review of imaging findings and any red flags for associated injuries
Follow-up – Re-evaluation over time, often with repeat imaging in some cases to confirm healing progression (frequency varies by clinician and case) – Rehabilitation planning to restore hip strength and gait mechanics as appropriate

Types / variations

Greater trochanter fractures can be described in several practical ways. Common variations include:

Isolated Greater trochanter fracture
The fracture line is limited to the greater trochanter region on imaging.
Clinical importance: clinicians often consider whether it is truly isolated or whether there is subtle extension.
Greater trochanter fracture with occult intertrochanteric extension
The greater trochanter component is visible, but additional fracture involvement may be detected on MRI/CT.
Clinical importance: may affect stability considerations and weight-bearing planning (varies by clinician and case).
Nondisplaced vs displaced
Nondisplaced: bone fragments remain aligned.
Displaced: fragments have shifted; the degree of displacement can influence abductor mechanics and treatment selection (varies by clinician and case).
Avulsion-type fracture
Often discussed when a tendon/muscle pull is a major contributor to fragment separation.
Can overlap with sports-related hip injuries and may require careful differentiation from tendon tears.
Periprosthetic Greater trochanter fracture
Occurs around a hip replacement, involving the trochanteric region adjacent to an implant.
Management depends on implant stability, fracture pattern, and bone quality (varies by material and manufacturer, and by case).
Pediatric/adolescent apophyseal injuries
In skeletally immature patients, growth centers (apophyses) can be involved; classification and terminology may differ from adult patterns.

Pros and cons

Pros:

Often a clearly localizable source of lateral hip pain after trauma
Many cases (especially stable, minimally displaced patterns) may be amenable to nonoperative management depending on imaging and symptoms
Diagnosis helps clinicians differentiate trauma-related pain from non-fracture causes like tendinopathy or bursitis
Imaging and classification can help predict functional issues, especially related to hip abductor mechanics
Follow-up assessment can track healing and return of function over time

Cons:

Can be missed or underestimated on initial X-rays, especially if there is occult extension (varies by clinician and case)
Pain can significantly limit walking and sleep, even when the fracture appears small
Displacement may affect abductor function, contributing to limp or fatigue during gait
Recovery may be complicated by osteoporosis or low bone density, increasing risk of additional injury
Distinguishing it from greater trochanteric pain syndrome (a non-fracture condition) can require careful clinical and imaging correlation
In postoperative hips, management decisions can be more complex due to implant and fixation considerations (varies by material and manufacturer)

Aftercare & longevity

Aftercare for a Greater trochanter fracture generally focuses on protecting healing bone, restoring hip motion and strength, and preventing secondary problems from reduced mobility. The specifics of restrictions and rehabilitation progressions vary by clinician and case, but common factors that influence outcomes include:

Fracture pattern and displacement: more displacement or complex patterns may require closer monitoring and, in some cases, surgical stabilization.
Presence of fracture extension: intertrochanteric extension can change stability considerations and may alter activity planning.
Bone health: osteoporosis and other metabolic bone conditions can affect healing and future fracture risk.
Weight-bearing status and gait mechanics: early overloading can be a concern in some patterns, while prolonged limping can contribute to deconditioning. Recommendations vary by clinician and case.
Rehabilitation participation: restoring abductor strength and balance is often important for long-term function, especially for stair climbing and single-leg stability.
Comorbidities: diabetes, smoking status, nutrition, and medications can influence healing capacity in general terms.
Follow-up adherence: follow-up visits and any repeat imaging can help ensure healing is progressing as expected and that symptoms match imaging findings.

“Longevity” in this context refers less to a device lifespan and more to long-term function. Some people recover with minimal residual symptoms, while others may experience ongoing lateral hip discomfort or weakness depending on associated tendon injury, displacement, and rehabilitation factors—varies by clinician and case.

Alternatives / comparisons

Because Greater trochanter fracture is a diagnosis, “alternatives” typically refer to (1) other diagnoses that can look similar and (2) different management pathways once the fracture is confirmed.

Compared with greater trochanteric pain syndrome (GTPS)

GTPS is a common non-fracture cause of lateral hip pain, often related to gluteal tendinopathy and bursae irritation.
A Greater trochanter fracture is a bony injury usually tied to trauma.
The overlap: both can cause tenderness over the lateral hip and pain when lying on the affected side. History (trauma vs gradual onset) and imaging help differentiate.

Compared with femoral neck or intertrochanteric fractures

Femoral neck fractures often cause groin pain and can have higher concern for complications related to blood supply to the femoral head (in general orthopedic teaching).
Intertrochanteric fractures involve the region between trochanters and are often treated as more structurally significant injuries.
A Greater trochanter fracture may be less extensive, but occult extension is a key reason clinicians may investigate further.

Management pathway comparisons (high level)

Observation/monitoring and activity modification may be considered for stable, minimally displaced patterns with appropriate follow-up (varies by clinician and case).
Pain control measures (medications, ice/heat approaches, and supportive devices) may be used as part of general fracture care; exact choices vary by clinician and patient factors.
Physical therapy/rehabilitation is commonly used to restore strength, gait, and balance after the acute phase.
Surgical fixation may be considered for displaced fragments, abductor mechanism compromise, or complex/periprosthetic scenarios. Fixation options (wires/cables, screws, plates, or constructs) vary by surgeon preference, implant environment, and case.

Imaging comparisons

X-ray: widely available and often first-line, but may not show subtle extension.
CT: can better define cortical bone detail and fragment position in many cases.
MRI: can detect bone marrow edema and occult fracture lines and can evaluate soft tissues; availability and appropriateness vary by case.

Greater trochanter fracture Common questions (FAQ)

Q: Where is the greater trochanter, and why does it matter?
The greater trochanter is the large bony bump on the outside of the upper femur. It matters because key hip stabilizer muscles attach there. When it is fractured, pain and weakness can affect walking and balance.

Q: Does a Greater trochanter fracture always require surgery?
Not always. Many cases—particularly those considered stable and minimally displaced—may be managed without surgery, while other patterns may be treated operatively. The decision depends on imaging findings, displacement, functional impact, and patient-specific factors—varies by clinician and case.

Q: What does the pain typically feel like?
Pain is often felt on the outside of the hip, especially with pressure (lying on that side) or when trying to walk. Some people also notice bruising or swelling around the lateral hip. Pain location can overlap with tendon or bursa conditions, so context and imaging are important.

Q: How is it diagnosed if the X-ray looks normal?
If symptoms and exam findings suggest a fracture despite a normal or uncertain X-ray, clinicians may order advanced imaging such as MRI or CT. These tests can show subtle fracture lines, extension patterns, or associated soft-tissue injury. The choice of imaging varies by clinician and case.

Q: How long does it take to heal, and how long do results last?
Bone healing commonly takes weeks to months, and full functional recovery may take additional time depending on strength and gait restoration. Once healed, the fracture does not “wear out,” but lingering symptoms can occur if there is tendon involvement, persistent weakness, or altered mechanics—varies by clinician and case.

Q: Will I be allowed to put weight on the leg?
Weight-bearing recommendations depend on fracture stability, displacement, pain level, and whether there is any extension into other parts of the proximal femur. Some cases allow earlier weight-bearing than others, and instructions differ across clinicians and institutions—varies by clinician and case.

Q: When can someone typically drive or return to work?
Driving and work timing depend on pain control, safe reaction time, leg function, and whether the injured side is needed for driving (often relevant for right-sided injuries). Job demands also matter; desk work differs from physically demanding work. Clinicians commonly individualize guidance—varies by clinician and case.

Q: What is the cost range for evaluation and treatment?
Costs vary widely based on setting (urgent care vs emergency department vs outpatient), imaging needs (X-ray vs CT/MRI), and whether surgery or inpatient care is required. Insurance coverage, region, and facility billing practices also affect totals. For that reason, cost is best discussed with the treating facility and payer.

Q: Is it the same as hip bursitis or gluteal tendinopathy?
No. Hip bursitis and gluteal tendinopathy are soft-tissue conditions, while a Greater trochanter fracture is a break in bone. Symptoms can be similar, and some people may have both, so clinicians rely on history, exam, and imaging to distinguish them.

Q: What are common complications clinicians watch for?
Clinicians commonly watch for missed fracture extension, delayed healing, persistent lateral hip pain, and ongoing abductor weakness affecting gait. In postoperative hips, they also monitor for issues related to implant stability and fixation integrity—varies by material and manufacturer, and by case. Follow-up plans are typically tailored to risk level and symptoms.