What is Greater Trochanter?
The greater trochanter is a prominence situated distal and lateral to the femur axis. It is named the lateral process of the femur or external trochanter. Trochanters are points at which the hip and thigh muscles are fixed.
Where is Greater Trochanter Located?
- The greater trochanter is a bony protrusion located in the upper extremity, or femur epiphysis.
- The greater trochanter is located at the junction between the neck and the shaft of the femur bone. It is the point of insertion of different muscles.
- The prominent convexity of the greater trochanter is the outermost part of the hip area.
- The greater trochanter is a large rectangular eminence located in the upper part of the femur, as a significant part of the skeletal system.
- It is one of the three tuberosities of the femur: the first one at the upper end on the lateral surface; the minor trochanter on the medial surface; and further away on the lateral surface the third trochanter is located.
Anatomy
- In the greater trochanter, the piriformis muscle, the superior gyrus muscle, the lower gyrus muscle, the internal obturator muscle, the external obturator muscle, the gluteus maximus muscle, and the gluteus medius muscle are inserted.
- Side surface of the greater trochanter: It is quadrilateral, broad, rough, convex and marked by an impression, which extends from the posterosuperior angle to the anteroinferior angle, and whose function is the insertion of the gluteal tendon. Higher up the impression, an angular subsurface is situated, like a base between the bone and the tendon.
- Medial surface of the greater trochanter: the trochanteric fossa for the insertion of the external obturator tendon is located, and above and in front of the fossa an impression for the insertion of the internal obturator and the twin muscles are located.
- Greater surface of the greater trochanter: It is thick and irregular, including the insertion of the pyramidal.
- Bottom surface of the greater trochanter: It is the union line of the base of the trochanter with the lateral surface of the body with a rough, prominent, slightly curved crest, leading to the upper area of the vast lateral.
Functions
Greater trochanter is the cuboid bone prominence, very flattened transversally, located outside and slightly below the articular head. Its external face, convex, is the crest of the median gluteus, where this muscle is inserted. The inner face, on the other hand, is vertically excavated. It has a deep depression, the digital cavity of the greater trochanter, where the external obturator, internal obturator and gemini muscles are inserted. The upper, almost horizontal edge brings itself to the pyramidal muscle. Some fascicles of the crural quadriceps – external vertebra – start from the lower border. At the posterior border, the crural square is inserted. Finally, the anterior border, very broad, gives insertion to the gluteus minor.
Greater Trochanter Pain
Causes
The regional pain syndrome located in the greater trochanter is usually related to the presence of inflammation of the peritrochanteric bursae. Multiple scientific investigations have found up to 21 synovial bursae around the hip, of which only three are constant. These are the subgluteal major bursae. Its biomechanical mission is to separate and limit the friction between the tendons of the gluteal musculature.
Experts in medicine believe that the inflammation of these structures is the cause of the major trochanter syndrome, although studies using magnetic resonance imaging of the hip have allowed to detect in the patient tendinous lesions.
Greater trochanter syndrome may have post traumatic origin, but often has an insidious onset, and a subacute course with variable clinical manifestations. Medical professionals describe this syndrome by associating it with other pathologies: rheumatic and degenerative diseases that affect the hip, obesity, fibromyalgia, etc. This pathology has also been associated with the biomechanical alterations of the walking action.
Treatment
The goal of treatment is to relax the irritated and inflamed muscles that cause the pain. The first step is to perform stretching to relax the area and improve the condition of muscle fibers, and also resort to physiotherapy or osteopathy. The exercises consist of stretching the entire back area of the leg. Patient have to mobilize the posterior muscles.
