Phillips C D, Pope T L, Jones J E, Keats T E, MacMillan R H
Department of Radiology, University of Virginia School of Medicine, Charlottesville.
Skeletal Radiol. 1988;17(2):106-10. doi: 10.1007/BF00365136.
Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy.
因创伤导致的小转子孤立性撕脱骨折在青少年运动员中最为常见，在成年人中则较为罕见。标准治疗方法是非手术治疗，包括卧床休息和腿部固定。然而，当在成年人中发现这种损伤且无明显创伤时，在排除其他原因之前应将其视为转移性肿瘤的继发性表现。治疗应采用手术，对髋关节进行预防性内固定，以帮助预防常见的相关转子下病理性骨折。对于未知原发性恶性肿瘤的患者，治疗前应进行活检。我们描述了4例因转移性癌导致小转子孤立性撕脱骨折的患者。放射科医生应了解这种病变，因为它的存在对治疗具有决定性影响。
