title: Partial greater trochanter osteotomy for hip reduction in total hip arthroplasty for high dislocated hip: a preliminary report.
abstract: BACKGROUND
  Hip reduction in total hip arthroplasty for high dislocated hips is difficult. Various femur osteotomy procedures have been used for hip reduction, but these methods increase operative time and risk of nonunion. We investigated the efficacy of a novel partial greater trochanter osteotomy technique for hip reduction in total hip arthroplasty for patients with high hip dislocation.
  
  
  METHODS
  Twenty-one patients (23 hips) with high dislocated hip were treated with total hip arthroplasty that included partial greater trochanter osteotomy, i.e., the upper 2/3 greater trochanter was resected, and the gluteus medius muscle attachment was spared. The clinical outcome was evaluated by comparing the Harris hip scores and radiographic exam results, obtained before surgery and at follow-ups.
  
  
  RESULTS
  Follow-ups of 21 patients ranged from 13 to 56 months. The mean Harris hip score increased from preoperative 55.0 (36-69) to postoperative 86.1 (71-93; P = 0.00). The average preoperative leg length discrepancy in patients with unilateral high hip dislocation was 46 mm (28-65 mm); postoperatively leg length discrepancy was less than 1 cm in 11 patients, between 1 and 2 cm in 8 patients, and more than 2 cm in 2 patients. The average leg lengthening at the time of surgery was 36 mm (24-54 mm). Trendelenburg's gait changed from positive to negative in 20 hips by the last follow-up. No nerve injury occurred postoperative.
  
  
  CONCLUSIONS
  Partial greater trochanter osteotomy is an effective method to render hip reduction in total hip arthroplasty for patients with high dislocation of the hip.
authors.forename: Rui Yu
authors.initials: RY
authors.lastname: Liu
authors.forename: Chuan Yi
authors.initials: CY
authors.lastname: Bai
authors.forename: Qi Chun
authors.initials: QC
authors.lastname: Song
authors.forename: Xiao Qian
authors.initials: XQ
authors.lastname: Dang
authors.forename: Yao Jun
authors.initials: YJ
authors.lastname: Wu
authors.affiliation: Department of Orthopaedic, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, No,157, Xiwu Road, Xi'an 710004, Shaanxi, P, R, China. kunzheng_wang@126.com.
authors.forename: Kun Zheng
authors.initials: KZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery*; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000000981:diagnostic imaging* / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult