trocánter

The trochanter, sometimes written trocánter, refers to two bony prominences near the proximal femur: the greater trochanter and the lesser trochanter. Located at the upper end of the femur, they serve as important attachment points for multiple hip muscles and as landmarks for hip movement.

The greater trochanter is a large lateral projection that provides the insertion sites for the gluteus medius and gluteus minimus, as well as the short external rotators such as the piriformis, superior and inferior gemellus, obturator internus, and sometimes the quadratus femoris. The lesser trochanter is a smaller posteromedial projection where the iliopsoas tendon attaches, playing a key role in hip flexion. Together, the trochanters act as prominent leverage points within the proximal femur for muscle function and hip mechanics.

Clinical relevance centers on conditions affecting this region. Greater trochanteric pain syndrome includes gluteal tendinopathy and trochanteric bursitis, causing lateral hip pain that can be aggravated by walking or lying on the affected side. In adolescents, avulsion fractures of the greater trochanter can occur with sudden, forceful muscle contraction. In older adults, trochanteric fractures are common after falls and may require surgical treatment.

Diagnosis and treatment involve clinical assessment and imaging such as X-ray, MRI, or ultrasound. Management ranges from rest, activity modification, NSAIDs, and physical therapy to strengthen hip abductors; corticosteroid injections can help bursitis. Persistent fractures or tendon pathology may necessitate surgical intervention, including fixation or bursectomy as appropriate.