[Complication rate following trochanteric osteotomy in total hip endoprosthesis. A retrospective study with failure...

In total hip arthroplasty extended approach, simplified luxation and improved exposure are the major advantages of trochanteric osteotomy. The main complication of the iatrogenic fracture is the nonunion which has occurred in about 20% of our patients (61 operations, 80% revision procedures). The rate of nonunion decreases using an optimized technique of reattachment, in particular; sufficient thickness of wires and placing of K-wires in the trochanter minor region. However, the bony nonunion has not necessarily an influence of the clinical outcome. Fibrous union provides in most cases satisfactory stability and function. In 3 patients revision surgery was necessary caused by the trochanter osteotomy: 2 suffered from a painful bursitis. In the 3rd case a strong abductor impairment occurred as the result of the trochanteric osteotomy. Refixation of the dislocated trochanter became necessary. Considering the risk of complications trochanteric osteotomy should be for exceptional cases only.