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Injury ; 43 Suppl 2: S55-8, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23622993

ABSTRACT

The posterior dislocation remains one unresolved complication of the posterior approach to the hip joint. In this study, a variation of the posterior hip approach - a partial osteotomy of the greater trochanter - was performed in order to investigate whether it provides better stability to the operated hip joint and reduces the risk of dislocation. We carried out a partial intertrochanteric osteotomy, initially in a cadaveric model and then in 68 patients (30 acute neck of femur fractures and 38 patients with hip osteoarthritis) requiring a total hip replacement. The osteotomised fragment was reattached with wires. All arthroplasties were cemented with Müller acetabular component and Charnley-type stem with a 28-mm interchangeable neck. Intraoperatively, all hips were tested for stability. After the osteosynthesis of the osteotomised fragment, hip dislocation points were increased more than 15% in the flexion and 10% in the internal rotation plane of movement. At one year follow up, no dislocation was observed in the clinical component of the study. This technique was found reliable in providing a stable hip joint.


Subject(s)
Arthroplasty, Replacement, Hip/methods , Femoral Neck Fractures/surgery , Femur/surgery , Fracture Fixation, Internal/methods , Hip Dislocation/surgery , Osteoarthritis, Hip/surgery , Osteotomy , Adult , Aged , Aged, 80 and over , Bone Cements , Bone Wires , Cadaver , Female , Femoral Neck Fractures/physiopathology , Femur/anatomy & histology , Hip Dislocation/physiopathology , Hip Dislocation/prevention & control , Humans , Male , Middle Aged , Osteoarthritis, Hip/physiopathology , Osteotomy/methods , Postoperative Complications , Range of Motion, Articular , Reproducibility of Results , Treatment Outcome , Weight-Bearing
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