Summary
This transtrochanteric approach to the hip maintains continuity between the greater trochanter and the vastus lateralis muscle, thereby preventing the gross displacement of the greater trochanter and preserving the branches of the lateral circumflex vessles to it. The procedure offers the advantages of easy exposure and a high rate of bony union between trochanter and femur. We have used the procedure in 189 consecutive operations; in only four cases did union between the bones not occur. The trochanter was never cranially displaced more than three cm, and even in the cases of non-union abductor power was good. Although we do not recommend trochanteric osteotomy for every case of total hip replacement, we suggest that the approach be used for cases where technical problems are anticipated.
Résumé
Cette voie d'abord trans-trochantérienne respecte la continuité entre grand trochanter et muscle vaste externe, permettant ainsi de prévenir les déplacements importants du grand trochanter et de respecter les branches des vaisseaux circonflexes qui lui sont destinées. Cette technique assure à la fois une bonne exposition et un risque minimum de non-consolidation: sur nos 189 patients, seuls 4 n'ont pas consolidé. Ces 4 patients, malgré leur pseudarthrose, ont une force d'abduction satisfaisante. Le déplacement du grand trochanter vers l'avant n'a jamais excédé trois cm. Bien que nous ne conseillions pas cette voie d'abord dans tous les cas, nous la préconisons chaque fois que des difficultés techniques paraissent à redouter.
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Lindgren, U., Svenson, O. A new transtrochanteric approach to the hip. International Orthopaedics 12, 37–41 (1988). https://doi.org/10.1007/BF00265739
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DOI: https://doi.org/10.1007/BF00265739