Abstract • Eleven human cadaver hips were dissected to define exactly the musculofascial anatomy of the greater trochanter and the supportive structures around it. A readily identifiable plane was defined that permitted osteotomy of the greater trochanter from an anterior approach leaving the vastus lateralis attached to it so that the trochanter could be folded posteriorly and then replaced securely. The osteotomy has been used in difficult total hip replacements at Waterbury (Conn) Hospital and found to be very satisfactory with no wire or bolt fixation necessary to maintain trochanter stability after surgery. Until a large series of these osteotomies has been reviewed, however, additional fixation may be advisable. (Arch Surg 114:19-21, 1979) References 1. Charnley J: Total hip replacement by low-friction arthroplasty. Clin Orthop 72:7-21, 1970. 2. Harris WH: A new approach to total hip replacement without osteotomy of the greater trochanter . Clin Orthop 106:19-26, 1975.Crossref 3. Keggi KJ, Light T: The anterior approach to total hip replacement. Exhibited at the annual meeting of the American Academy of Orthopaedic Surgeons, February 1977, Las Vegas. 4. Thompson RC, Culver JE: The role of trochanteric osteotomy in total hip replacement . Clin Orthop 106:102-106, 1975.Crossref 5. Volz RG, Turner RH: Reattachment of the greater trochanter in total hip arthoplasty by use of a bolt . J Bone Joint Surg (Am) 57:129-130, 1975. 6. Parker HG, Wiesman HG, Ewald FC, et al: Comparison of preoperative, intraoperative, and early postoperative total hip replacements with and without trochanteric osteotomy . Clin Orthop 121:44-49, 1976. 7. Rouviere H: Anatomie Humaine . Paris, Masson et Cie, 1924. 8. Tandler J: Lehrbuch der Systematischen Anatomie . Leipzig, Verlag von FCW Vogel, 1926. 9. Anson BJ: An Atlas of Human Anatomy . Philadelphia, WB Saunders Co, 1950. 10. English TA: The trochanteric approach to the hip for prosthetic replacement . J Bone Joint Surg (Am) 57:1128-1133, 1975.
Archives of Surgery – American Medical Association
Published: Jan 1, 1979
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