Distal transfer of the greater trochanter for the correction of trochanteric overgrowth.
For the correction of trochanteric overgrowth resulting from ischaemic necrosis following conservative therapy in early childhood for congenital dislocation of the hip, 83 trochanteric transfers were carried out whose results were analysed over a mean follow-up period of 4.5 years (3-10 years). During operation the insertion of the gluteal minimus muscle to the trochanter was carefully detached in a way that only the fibres of the gluteus medius remained on the bone. Thus the gluteus medius could maximally be stretched in isolation, by a distal transfer of the greater trochanter and that was the way for obtaining the best results. To prevent subluxation of the head of the femur surgical correction of the acetabulum was carried out (usually Chiari's pelvic osteotomy) if the covering of the head was imperfect. The trochanter was fixed using A0 cancellous bone screw, no plaster fixation was applied and full loading was allowed 4 weeks after surgery. On the basis of changes in Trendelenburg's sign in patients operated before the age of 14 years, good results were found in 92%, whereas in older patients the result was 75%. Subjective opinions were quite similar in both groups. Positive evaluation of the results was given in 70% and 68% by patients in the younger and older group, respectively.
Szepesi
K
K
Department of Orthopaedic Surgery, University Medical School, Debrecen, Hungary.
Fazekas
K
K
Biró
B
B
Gáspár
L
L
D000293:Adolescent; D000328:Adult; D001852:Bone Lengthening / Q000379:methods; D001863:Bone Screws; D002648:Child; D005260:Female; D005269:Femur / Q000254:growth & development / Q000601:surgery*; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000628:therapy; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D010027:Osteotomy