The greater trochanter (from the Greek trokhantêr) constitutes one of the parts of the femur, the single bone of the thigh located between the hip and the knee.

Position. The greater trochanter is positioned on the upper part of the connection of the neck and the head of the femur. Elongated in shape, the latter constitutes the longest bone and represents on average a quarter of the size of the body. (1) It is also the largest bone in the human body and is made up of three parts:

• a proximal end, located at the hip and made up of three parts (1):

  – the head of the femur, located in the acetabulum, the articular cavity of the coxal bone, which forms the hip;

  – the neck of the femur which connects the head to the diaphysis;

  – the large and the small trochanters, bony projections, which are positioned at the level of the connection of the neck and the head.

• a distal end, located at the level of the knee;
• a diaphysis, or body, central part of the bone located between the two ends.

Structure. The greater trochanter is a bony protrusion that constitutes a zone of insertions for many muscles (2):

• the pyramidal muscle on its upper surface;
• the gluteus medius (or gluteus medius) and vastus lateralis muscles on its lateral surface;
• the gluteus minimus (or gluteus minimus) and vastus lateralis muscles on its anterior surface;
• obturator and twin muscles on its medial surface

Weight transmission. An integral part of the femur, the greater trochanter is involved in the transmission of body weight from the hip bone to the tibia. (3)

Body dynamics. Given the different insertion points for the muscles, the greater trochanter contributes to the body’s ability to move and to maintain the upright posture. (3)

Pain may be felt in the greater trochanter. This is usually referred to as painful syndrome of the greater trochanter (4). The causes of this pain are varied but can in particular be of traumatic, congenital or even tumoral origin.

Bone diseases. The greater trochanter can be affected by bone pathologies.

• Osteoporosis. This pathology constitutes a loss of bone density which is generally found in people over the age of 60. It accentuates bone fragility and promotes bills. (5)
• Bone cancer. Metastases can develop in the bones. These cancer cells usually originate from primary cancer in another organ. (6)

Femoral fractures. The most common femoral fractures are those in the neck of the femur, especially in older people with osteoporosis. They can also occur in the greater trochanter. Fractures of the femur are manifested by pain in the hip.

Coxarthrosis. This pathology corresponds to the wear and tear of the cartilage of the hip joint.

Tendinopathies trochantériennes. Occurring in the tendons, tendinopathies can occur in the region of the greater trochanter (4). They are mainly manifested by pain during exertion. The causes of these pathologies are varied and can be of both intrinsic origin with genetic predispositions, and extrinsic, with for example bad positions during sports practice.

Medical treatment. Depending on the condition diagnosed, certain drugs may be prescribed to regulate or strengthen bone tissue, as well as to decrease pain and inflammation.

Surgical treatment. Depending on the type of fracture, surgery can be performed with the placement of pins, a screw-retained plate, an external fixator or in some cases a prosthesis.

Orthopedic treatment. Depending on the type of fracture, the installation of a plaster or a resin can be carried out.

Physical treatment. Physical therapies, such as physiotherapy or physiotherapy, may be prescribed.

Hormonal treatment, radiotherapy or chemotherapy. These treatments may be prescribed depending on the type and stage of the cancer.

Physical examination. The diagnosis begins with an assessment of the pain perceived by the patient in the lower limb and pelvis.

Medical imaging exam. Depending on the suspected or proven pathology, additional examinations may be performed such as an X-ray, an ultrasound, a CT scan, an MRI, a scintigraphy or even a bone densitometry.

Medical analysis. In order to identify certain pathologies, blood or urine analyzes can be carried out such as, for example, the dosage of phosphorus or calcium.

Bone biopsy. In some cases, a bone sample is taken to confirm a diagnosis.

In December 2015, the magazine PLOS ONE unveiled an article relating the discovery of a human femur from a premodern species. (7) Discovered in 1989 in China, this bone was not studied until 2012. Dating back 14 years, this bone seems to belong to a species approaching theHomo handy orHomo erectus. Primitive humans could thus have survived until the end of the last Ice Age, 10 years ago. This discovery could suggest the existence of a new evolutionary lineage (000).