Caption: Figure 1: Anatomy of the subtrochanteric area of the femur: the subtrochanteric area of the femur is defined as the area 5 cm distal to lesser trochanter
On physical exam, a positive Ludloff sign helps localize the injury to the iliopsoas muscle, which inserts at the lesser trochanter
and is involved in hip flexion.
The intracortical and extracortical dimensions of the cross-sections were generally bigger in KD than it were in GSD except that the medio-lateral dimensions at the isthmus and at the mid-shaft, the intracortical width of midshaft in cranio-caudal direction and extracortical width the lesser trochanter
level in the medio-lateral direction (Table 1).
(8) On MRI, decreased space between the ischium and lesser trochanter
is often identified as a risk for IFI.
Intertrochanteric fractures are those occurring along a line joining the greater and lesser trochanter
. Subtrochanteric fractures are those occurring between lesser trochanteric and a 5 cm distally (isthmus).
amputate at the level of the lesser trochanter
as this provides a buttock contour and once the stump has healed the patient is able to sit comfortably.
Also, the femoral head, the ischiadic tuberosities (the lowest parts of the pelvis), the greater and the lesser trochanter
can be approximated by parts of circles.
Furthermore, prosthetic replacement is associated with problems in such a fracture as it extends beyond the lesser trochanter
involving the calcar and will leave a gap on the medial aspect, after a routine neck cut is made.
One of the most frequently affected muscles is the iliopsoas, the main flexor of the thigh, which originates in the retroperitoneum in the bodies of the lumbar vertebrae and crosses the pelvis before its insertion in the lesser trochanter
of the femur.
Psoas major and minor both insert on the lesser trochanter
of the femur (4).
On hip scans, be sure the hip was imaged in the correct position, with the femoral shaft straight up and down and with sufficient internal rotation on the leg so that little or none of the lesser trochanter
The iliopsoas runs in your abdomen behind the organs, along the front of the spine, and ends at a point in the inner leg called the lesser trochanter
. A great visual image used by yoga guru Rodney Yee describes the psoas as lying on the front of the spine like a long lizard basking in the warm sun over the big desert rock of the lumbar spine.