Greater trochanter apophyseal avulsion in the adolescent managed conservatively: A case report of a sporting injury presenting with knee pain

Isolated Epiphyseal Detachment of the Greater Trochanter in a Judoka

“…Isolated avulsion fracture of the greater trochanter is a rare entity [6], about 11 cases in total have been published. Most often, it is secondary to violent trauma.…”

Isolated Apophyseal Avulsion of the Greater Trochanter Treated by Minimally Invasive Osteosynthesis: A Case Report

“…An analysis of the literature reveals that avulsion fractures of the greater trochanter are a rare injury among the paediatric population, but it may frequently lead to subsequent development of avascular necrosis of the femoral head 1 - 5 . This serious complication is possible in young patients: whilst the physis is open the lateral ascending cervical artery and the medial circumflex femoral artery provide vascular supply to the femoral head 1 .…”

“…An analysis of the literature reveals that avulsion fractures of the greater trochanter are a rare injury among the paediatric population, but it may frequently lead to subsequent development of avascular necrosis of the femoral head 1 - 5 . This serious complication is possible in young patients: whilst the physis is open the lateral ascending cervical artery and the medial circumflex femoral artery provide vascular supply to the femoral head 1 . AVN of the femoral head after greater trochanter apophyseal avulsion could occur due to a lesion of these vessels: the causes include vessels traction or injury as a direct consequence of the trauma or indirect of the intracapsular hematoma or iatrogenic vascular damage at the time of the surgery 1 - 2 .…”

“…Giles reported excellent treatment outcome in a 14 years old boy with a minimally displaced greater trochanter avulsion fracture managed with a hip abduction brace and limit weight-bearing 5 . Finally, O’Rourke and Weinstein described two cases of AVN both after conservative and surgical management, in a 5-year-old and a 13-year-old patient, respectively 2 , whereas Macdonald et al presented a 14-year-old patient with greater trochanter avulsion successfully managed non-operatively 1 .…”

“…Isolated avulsion of the greater trochanter apophysis is a rare condition in the paediatric population and is generally due to direct trauma or a sudden contraction against resistance in the gluteus muscles. In the published literature, this injury has been reported in very few cases and it is frequently associated with avascular necrosis (AVN) of the femoral head 1 - 2 . Other complications are not reported in the literature.…”