Overview
A greater trochanter fracture is a break in the bony bump on the outside of the hip where the hip abductor muscles attach. It most often happens after a fall directly onto the outer hip or after a sudden forceful contraction that can pull on the tendon attachment. When the bone and nearby soft tissues are injured, you may have difficulty bearing weight, moving the hip normally, and stabilizing the pelvis during walking. Pain is commonly felt on the outside of the thigh and may persist until healing and gradual strengthening restore control of the hip.
Symptoms
Pain is usually felt on the outer (lateral) hip and may spread toward the outer thigh. Activities that load the hip such as standing, walking, climbing stairs, or lying on the affected side often make symptoms worse. You may notice weakness in hip lifting/side-stepping, a limp, or trouble getting comfortable at night. In some cases, bruising and swelling appear after the injury, and movement can feel limited by pain.
Causes
Greater trochanter fractures typically occur after trauma, most commonly a fall onto the outside of the hip, or less commonly after a sudden twisting or twisting-with-impact injury. In some patients, the injury is an avulsion, where the hip abductor tendon pulls off a fragment of bone. The fracture and irritated surrounding tendons can disrupt hip stability, leading to pain with weight-bearing.
Risk Factors
Risk increases with age-related bone thinning, especially osteoporosis, and with a higher likelihood of falls. Prior hip surgery, weakness of the hip muscles, and balance problems can also make injury more likely. Sudden falls during sports or daily activities, as well as medical conditions that raise fall risk, are common contributing factors.
Prevention
To reduce risk, focus on fall prevention with good lighting, removing loose rugs, appropriate footwear, and balance-focused exercise if you are at risk for falls. If osteoporosis or low bone density is present, addressing it with your clinician can help lower fracture risk. Building hip strength and maintaining mobility through regular, safe strengthening and conditioning can improve control and reduce the chance of landing directly on the outer hip.
How the Diagnosis Is Evaluated
Clinicians start with an injury history, including how the fall or force occurred and whether you can bear weight. A physical exam checks tenderness over the greater trochanter, hip range of motion, pain with resisted hip abduction, and how well you can walk. Imaging often begins with X-rays, and if the fracture is not clearly visible or symptoms are significant, MRI or CT may be used to confirm the fracture and assess associated tendon or soft-tissue injury.
Nonsurgical Treatment Options
Treatment usually focuses on pain control, protecting healing bone, and restoring hip strength and function. Many patients benefit from temporary activity modification with protected or limited weight-bearing as advised, along with assistive devices such as a cane or walker to reduce stress on the healing area. Physical therapy commonly includes gentle range-of-motion early on and then gradual strengthening of the hip abductors and core to improve pelvic stability. Ice or heat, plus non-prescription or prescription pain medicines as appropriate for your medical history, can help you move more comfortably. If pain persists after healing and evaluation suggests associated trochanteric bursitis or abductor tendinopathy, clinicians may consider a corticosteroid injection or biologic options such as platelet-rich plasma (PRP) to reduce inflammation and improve tendon-related pain in selected cases.
When to Seek Medical Attention
Seek prompt medical attention after a fall if you have significant lateral hip pain, new inability to bear weight, or a limp that does not improve. Get urgent care if pain rapidly worsens, you develop fever, or you notice progressive numbness, weakness, or inability to move the leg. If swelling is severe, there is major bruising, or you cannot take a few steps even with support, it is important to be evaluated quickly to rule out more extensive hip or pelvic injury.
Frequently Asked Questions
Many people can bear some weight, but it depends on the fracture stability and pain level, so follow your clinician's protected-weight-bearing guidance.
It is a type of hip-area fracture, but it is not the same as a femoral neck fracture, and treatment depends on which bone and structures are involved.
Next Steps
If you suspect a greater trochanter fracture after a fall or sudden hip injury, arrange an in-person evaluation for exam and imaging guidance. Follow activity and weight-bearing recommendations closely, and ask whether physical therapy is appropriate for your healing stage. If symptoms are severe or you cannot bear weight, seek prompt care to rule out more serious hip or pelvic injury.