title: Trochanteric fixation in total hip arthroplasty using the S-ROM bolt and washer.
abstract: We evaluated the S-ROM bolt and washer (DePuy, Inc, Warsaw, IN) for fixation of the greater trochanter after trochanteric osteotomy in 29 hips in 28 consecutive patients. Of 29 cases, 9 (31%) resulted in trochanteric nonunion, with bony union being achieved in only 38% of cases. There was dislocation and subluxation in 7 of 29 (24%) cases with 6 of the 7 dislocations associated with trochanteric nonunion. Revision was necessary in 4 of 8 hips to obtain fixation of the trochanter. The rate of complications in this series suggests that the S-ROM bolt and washer is associated with a high rate of nonunion, particularly in the multiply-revised hip. Avoidance of trochanteric osteotomy whenever possible would be desirable. When an osteotomy is necessary, alternative forms of fixation should be considered.
authors.affiliation: Department of Orthopaedics, University of Arizona, Tucson, Arizona 62794-9638, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Chilvers
authors.forename: Hank
authors.initials: H
authors.lastname: Vejvoda
authors.forename: Rita
authors.initials: R
authors.lastname: Trammell
authors.forename: D Gordon
authors.initials: DG
authors.lastname: Allan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005269:Femur / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies