A Best Evidence Topic review was undertaken to clarify whether patients with apparently isolated greater trochanter fracture on plain X-ray require urgent cross sectional imaging. A literature search was performed to establish what proportion of these patients have clinically important intertrochanteric extension. 11 papers were included showing intertrochanteric extension in 54% using magnetic resonance imaging and computed tomography and surgical management was in 37% but with marked disparity in the data. Further work is needed to completely answer this question, and to find the most clinically useful predictors of fracture completion and displacement.
Patange SubbaraoSPManoharanGRobertsPJ. Management of isolated greater trochanteric fractures of the hip – Experience from a major trauma centre over a 24-month period. Trauma2021; 0(0): 1–7. DOI: 10.1177/14604086211030803.
2.
NohJLeeKHJungS, et al.The frequency of occult inter-trochanteric fractures among individuals with isolated greater trochanteric fractures. Hip Pelvis2019; 31(1): 23–32. DOI: 10.5371/hp.2019.31.1.23.
3.
MoonNHShinWCDoMU, et al.Diagnostic strategy for elderly patients with isolated greater trochanter fractures on plain radiographs. BMC Musculoskelet Disord2018; 19: 256.
4.
ParkJHShonHCChangJS, et al.How can MRI change the treatment strategy in apparently isolated greater trochanteric fracture?Injury2018; 49: 824–828.
5.
ThurstonDMarsonBOllivereB, et al.The management of isolated greater trochanter fractures: is cross-sectional imaging necessary?HIP Int2018; 28: 15–16.
6.
WongWYChuPYChanSWC, et al.Occult inter-trochanteric extension in isolated greater trochanteric fracture on plain radiographs. Hong Kong J Radiol2016; 19: 28–34.
7.
LeeKHKimHMKimYS, et al.Isolated fractures of the greater trochanter with occult inter-trochanteric extension. Arch Orthop Trauma Surg2010; 130: 1275–1280.
8.
FeldmanFStaronRB. MRI of seemingly isolated greater trochanteric fractures. Am J Roentgenol2004; 183: 323–329.
9.
LearchTPathriaM. Greater trochanter fractures: MR assessment and its influence on patient management. Emerg Radiol2000; 7: 89–92.
10.
CraigJGMoedBREylerWR, et al.Fractures of the greater trochanter: inter-trochanteric extension shown by MR imaging. Skeletal Radiol2000; 29: 572–576.
11.
OmuraTTakahashiMKoideY, et al.Evaluation of isolated fractures of the greater trochanter with magnetic resonance imaging. Arch Orthop Trauma Surg2000; 120: 195–197.
12.
National Institiute for Health Care and Excellence. The Management of Hip Fracture in Adults. [Internet]. London: NICE, 2011. [updated 2017 May; cited 2021 August 27]. (Clinical guideline [CG124]). Available from:https://www.nice.org.uk/guidance/cg124
13.
KimSJAhnJKimHK. Kim JH is magnetic resonance imaging necessary in isolated greater trochanter fracture? A systemic review and pooled analysis. BMC Musculoskelet Disord2015; 16: 395.
