The greater trochanter is a large, irregularly shaped bony structure that forms a distinct projection at the upper end of the femur, the long bone of the thigh. This prominence serves as a major anatomical landmark in the hip region, acting as a point of leverage and attachment for several powerful muscles. Its position and size contribute significantly to the biomechanics of walking, running, and maintaining balance. The greater trochanter is a common reference point for medical professionals during physical examinations and surgical procedures involving the hip.
Anatomical Location and Physical Identification
The greater trochanter is located on the lateral side of the proximal femur, positioned where the femoral neck meets the shaft of the bone. It is the most prominent outward projection of the entire femur, making it a key bony landmark easily felt beneath the skin and muscle. The structure is roughly level with the horizontal plane that passes through the pubic tubercle, sitting inferior to the midpoint of the iliac crest of the pelvis.
A person can physically locate this structure by placing a hand on the side of the hip and sliding it down toward the upper thigh. The hard, distinct bony bump felt is the greater trochanter, which often defines the widest point of the hip region. This location is also covered by a small, fluid-filled sac called a bursa, which helps reduce friction between the bone and the overlying tendons.
Role in Movement: Muscle Attachments
This bony projection functions primarily as an attachment site, increasing the mechanical advantage, or leverage, for the muscles of the hip. By extending outward from the shaft of the femur, the trochanter increases the distance between the joint’s center of rotation and the muscle’s pull. This extended lever arm allows the attached muscles to generate greater torque, facilitating movements around the hip joint.
The greater trochanter serves as the main insertion point for the gluteus medius and gluteus minimus muscles, which are primarily responsible for hip abduction, moving the leg away from the midline of the body. These muscles also stabilize the pelvis when standing on one leg, preventing the hip from dropping during the walking cycle. Several deep external rotators, including the piriformis, obturator internus, and the superior and inferior gemelli, attach to the trochanteric fossa, contributing to the lateral rotation of the thigh.
Common Conditions Affecting the Greater Trochanter
Due to its prominence and the convergence of multiple tendons and bursae over its surface, the greater trochanter is a frequent site of pain and injury. The most common pathology is Greater Trochanteric Pain Syndrome (GTPS), which describes chronic pain over the side of the hip. GTPS is often caused by inflammation and injury to the tendons of the gluteus medius and minimus, known as gluteal tendinopathy. Although historically called trochanteric bursitis, gluteal tendon issues are now understood to be the primary pain source in most cases.
Symptoms of GTPS include localized tenderness when pressure is applied directly over the bony prominence, and pain that increases when lying on the affected side at night. The pain can also be aggravated by activities like walking, standing for long periods, or climbing stairs. Fractures of the upper femur near the greater trochanter are classified as intertrochanteric fractures, which often require surgical repair.