Isolated lesser trochanter fractures in elderly--a case for prophylactic DHS fixation. A case series.
Isolated lesser trochanter fractures are a rare presentation of hip fractures in the elderly. Classically, lesser trochanter fractures in adults are associated with tumours and result from little or no trauma. We present three elderly osteoporotic ladies who sustained isolated fractures of the lesser trochanter secondary to a definite history of trauma. Radiologically, none of them showed any evidence of pathological lesions or intertrochanteric fracture at presentation. Two patients subsequently developed displaced intertrochanteric fractures, which necessitated internal fixation. In the third patient, a dynamic hip screw (DHS) was inserted before mobilisation. Based on this experience, we recommend careful observation and follow-up of such cases and suggest that isolated lesser trochanteric fractures in the elderly osteoporotic population may be an indication for prophylactic DHS fixation.
Bonshahi
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Department of Orthopaedics, Royal Bolton Hospital, Minerva Road, Farnworth, BL4 0JR, Bolton, UK. abonshahi@doctors.org.uk
Knowles
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D
Hodgson
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SP
D000061:Accidents, Home; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D017809:Fatal Outcome; D005260:Female; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010024:Osteoporosis / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D011859:Radiography