Non-Union of Greater Trochanter Following Low Friction Torque Arthroplasly (LFTA) / 대한정형외과학회잡지

ABSTRACT

This paper is intended to draw attention to the cases of non-union of reattached greater trochanter after LFTA for hip disorders with an our short experience of this subject. Previous information on this subject is scanty. Charnley mentioned on his paper of the long time result of LFTA of the hip for non-union of the great trochanter was reported in 4.2% of 379 hips followed for a minium of four years. Of these, a quarter went on to separation of the bony fragment. With his report, wire breakage occured in 28 cases in the presence of a united trochanter, a phenmenon which results from loops of the wire passing through soft tissues, out side the bone, and becoming fatigued by repeated bending movements. However, he pointed that the clinical result does not seems to be impaired althrough such patients occasionally complain of a feeling of insecurity when weight bearing. Among our series, two cases of non-union of the greater trochanter, after LFTA, is reported. Those of two patient were bilateral hip disorders who has indicated both hip total hip replacement. But we have done only one hip each because of inevitable patients physical conditions during the surgery. Presumably, the principal cause of non-union appeared to be excessive force on the operated one hip. The type of internal fixation for reattachment of the greater trochanter was investigated, six types which we used in this series, two separate knots for security of wire breakage after Bechtol resulted satisfactory union of the detached greater trochanter. A case of detached trochanter for revision which we used original Charnley technique with additional figure of eight wire fixation for re-enforcement. Eventually, we agree that advantage of bilateral total hip replacement at the same operative session.