title: Intertrochanteric partial osteotomy for posterior hip approach.
abstract: The posterior dislocation remains one unresolved complication of the posterior approach to the hip joint. In this study, a variation of the posterior hip approach - a partial osteotomy of the greater trochanter - was performed in order to investigate whether it provides better stability to the operated hip joint and reduces the risk of dislocation. We carried out a partial intertrochanteric osteotomy, initially in a cadaveric model and then in 68 patients (30 acute neck of femur fractures and 38 patients with hip osteoarthritis) requiring a total hip replacement. The osteotomised fragment was reattached with wires. All arthroplasties were cemented with Müller acetabular component and Charnley-type stem with a 28-mm interchangeable neck. Intraoperatively, all hips were tested for stability. After the osteosynthesis of the osteotomised fragment, hip dislocation points were increased more than 15% in the flexion and 10% in the internal rotation plane of movement. At one year follow up, no dislocation was observed in the clinical component of the study. This technique was found reliable in providing a stable hip joint.
authors.affiliation: Department of Orthopedics, Hospital General de Agudos Juan A. Fernández, Buenos Aires, Argentina. hacbagenova@gmail.com
authors.forename: Horacio Alberto
authors.initials: HA
authors.lastname: Caviglia
authors.forename: Gustavo Alberto
authors.initials: GA
authors.lastname: Galatro
authors.forename: Victor
authors.initials: V
authors.lastname: Vatani
authors.forename: Ernesto
authors.initials: E
authors.lastname: Abella
authors.forename: Guillermo Esteban
authors.initials: GE
authors.lastname: Cambiaggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D001864:Bone Wires; D002102:Cadaver; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000033:anatomy & histology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006617:Hip Dislocation / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D001843:Bone Cements