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Triple Surgical Fixation Technique for an Isolated Greater Trochanter Fracture in an Amateur Weightlifter
Brent Sanderson1, Frederic Washburn, Daniel Allison
1From the Department of Orthopedic Surgery, Community Memorial Health System, Ventura, CA (Dr. Sanderson, and Dr. Washburn); the Cedars-Sinai Medical Center (Dr. Allison); University of Southern California and L.A. County (Dr. Allison); Cedars-Sinai Division of Orthopedic Oncology (Dr. Allison); Children's Hospital of Los Angeles (Dr. Allison); and Medical Corps, United States Navy Reserve (Dr. Allison).
Abstract:
Isolated greater trochanter fractures have been infrequently described in the literature and are typically managed conservatively. Functional strength after injury to the abductor complex can be markedly affected resulting in a Trendelenburg gait and overall abductor weakness. We present a case of a 35-year-old athlete who underwent surgical fixation because of notable fracture displacement and function debility. This case vignette demonstrates the importance of using all available interdisciplinary orthopaedic surgery literature to provide a patient-specific surgical construct. Our patient benefitted from arthroscopic, arthroplasty, and trauma evidence-based medicine to successfully treat his displaced greater trochanteric hip fracture. Successful surgical fixation was enhanced by combining three different methods of fixation: osteosynthesis with partially threaded screws and washers (DePuy Synthes), suture anchor (Arthrex) direct fracture approximation and tendon reinforcement, and a knotless double-row suture bridge (Arthrex) tension band construct. The patient was able to return weightlifting at 4 months postoperatively with no evidence of weakness or trendelenburg gait.

