The painful migrated ununited greater trochanter in total hip replacement

The migrated painful ununited trochanter following total hip replacement can provoke a significant degree of functional disability. Although this condition is infrequently observed after total hip replacement, its occurrence causes definite problems for its operative management. A technique employing the trochanteric bolt for reattachment of the migrated painful trochanteric fragment is described. The results of this approach in five patients to date are relief from pain and decreased disability in all five. The factors promoting migration of the osteotomized fragment include the quality of the trochanteric bone, the stresses placed on the osteotomy site by the patient during the postoperative period, and the precise method of reattachment of the trochanter at the time of total hip replacement.