Complications involving the Greater Trochanter Associated with the Modified Transgluteal Approach(Dall)for THA Michitaka Kato 1 , Koji Noguchi 2 , Shigeki Sugitani 1 , Toshiro Takatsu 1 , Yuji Ishikawa 1 , Takefumi Nakagawa 1 , Yoshiyasu Kawada 1 1Department of Orthopaedic Surgery,Gifu Municipal Hospital Keyword: total hip arthroplasty(人工股関節全置換術) , greater trochanter(大転子) , complications(合併症) pp.695-699
Published Date 2004/5/1
DOI https://doi.org/10.11477/mf.1408100452
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Dall's modified transgluteal approach was used to perform and 121 total hip arthroplasties at our institution between 1993 and 2002,complications involving the greater trochanter developed in 26 of them. Follow-up radiographs could be evaluated in 118 cases(OA 78,RA 40). A fracture of the remaining greater trochanter had occurred in eleven cases. The rate of complication by fracture was 6.1%in OA and 15%in RA. Two of the fractures occurred during surgery,and the other nine occurred within 2 weeks after surgery. Three patients required open reduction and internal fixation,and sound union resulted in all three cases. Union was achieved in four of the eight patients treated conservatively. Proximal displacement(>10mm)of the osteotomized fragment occurred in fifteen patients,and the complication rate was 16%in OA and 5%in RA. Nonunion after reattachment was diagnosed in six patients on the basis of lateral view radiographs of the hips. Dislocation of the greater trochanter occurred as a complication in three hips. This study suggests that complications in greater trochanter are a risk factor for dislocation of the hip.

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