Fracture of the Greater Trochanter in Total Hip Arthroplasty Using the Anterolateral Approach

DOI 1 Citations 10 References
  • Okano Toru
    Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
  • Hayashibara Masako
    Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
  • Kawaguchi Kei
    Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
  • Otsuki Ryoji
    Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
  • Teshima Ryota
    Department of Orthopaedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan

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  • 前側方進入法における大転子骨折の問題点

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Two hundred fifty-eight primary total hip arthroplasties (THA) were performed via the anterolateral approach at this institution between March 2000 and December 2008.<BR>A fracture of the greater trochanter developed in 6 cases (2.3%). No fractures occurred from 2000 to 2005, 1 occurred in 2006, 1 in 2007, and 4 in 2008.<BR>Three oblique fractures of the greater trochanter occurred intraoperatevely. The other 3 transverse fractures of the greater trochanter all occurred postoperatively.<BR>All oblique fractures were fixed with wires, and displacement of the greater trochanter and posterior dislocation of the hip occurred in one case of three cases.<BR>All transverse fractures were followed up without any treatment, and no complications occurred except for non-union, which occurred in two of three cases.<BR>While the skin incisions have gradually become smaller since 2003, there was also an increased incidence of fracture of the greater trochanter after 2005.<BR>This indicates that careful manipulation is necessary to avoid fractures of the greater trochanter when manipulating the femur in THA via the anterolateral approach with a small incision. Proper bone fixation is required for oblique fractures of the greater trochanter, because such cases may result in the posterior instability of the hip.

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