Anatomy and osteotomy of the greater trochanter

Area of Science:

• Orthopedic Surgery
• Anatomy

Background:

• The greater trochanter is a key bony landmark in hip anatomy.
• Accurate visualization and manipulation of the greater trochanter are crucial for successful hip replacement surgery.

Purpose of the Study:

• To define the musculofascial anatomy of the greater trochanter.
• To develop a reliable surgical approach for greater trochanter osteotomy during hip replacement.

Main Methods:

• Dissection of eleven human cadaver hips to map musculofascial attachments.
• Identification of a surgical plane for anterior osteotomy of the greater trochanter.
• Evaluation of the technique in challenging total hip replacements.

Main Results:

• A distinct anatomical plane was identified, facilitating osteotomy.
• The vastus lateralis remained attached, allowing posterior folding of the trochanter.
• The technique proved satisfactory in difficult hip replacements, obviating the need for wire or bolt fixation.

Conclusions:

• A novel anterior osteotomy technique for the greater trochanter is described.
• This method offers secure repositioning and stability in total hip arthroplasty.
• Further review of a larger patient series is recommended before abandoning supplementary fixation.