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Extended trochanteric osteotomy: planning, surgical technique, and pitfalls
R M Meek1, Nelson V Greidanus, Donald S Garbuz
1Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia.
Instructional Course Lectures
|May 1, 2004
Summary
The extended trochanteric osteotomy provides crucial surgical exposure for complex hip revisions and femur deformities. This technique aids in removing difficult implants and improving outcomes in infected cases.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- The extended trochanteric osteotomy is a surgical approach used in hip revision arthroplasty.
- It provides enhanced visualization and access to the proximal femur and acetabulum.
Purpose of the Study:
- To outline the indications and benefits of the extended trochanteric osteotomy.
- To highlight its utility in complex hip revision surgeries.
Main Methods:
- The extended trochanteric osteotomy involves a controlled fracture of the greater trochanter.
- This allows for improved exposure of the femoral stem and acetabulum.
- Preservation of soft-tissue attachments facilitates abductor muscle function.
Main Results:
- Facilitates removal of well-fixed cemented and cementless femoral stems.
- Enables correction of proximal femoral deformities, such as varus remodeling.
- Reduces the risk of greater trochanter fracture.
- Crucial for eradicating infection by allowing complete removal of foreign material.
- Enhances acetabular exposure for complex reconstructions.
Conclusions:
- The extended trochanteric osteotomy is a versatile and valuable technique for various challenging hip revision scenarios.
- It offers significant advantages in implant removal, deformity correction, infection management, and complex acetabular reconstructions.