Der Orthopäde
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Fractures of the proximal femur are among the most common fractures of all bones. Currently nearly every trauma surgeon has to be able to treat proximal femur fractures either with osteosynthesis or with a prosthesis. An increase of 200-300 % of fractures of the proximal femur is expected within the next 30 years. In addition an increase of periprosthetic fractures of the proximal and distal femur can be observed. The correct treatment of these complications is a challenging objective for the trauma surgeon. ⋯ Due to the increasing incidence of fractures of the proximal femur on the one hand and complications after operative treatment of these fractures on the other, the trauma surgeon must provide differentiated therapy concepts depending on the individual risk factors of different patients. Moreover, trauma surgeons must know how to treat the potential complications of these procedures.
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Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. ⋯ Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90 %. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases.