Sambandam Senthil Nathan, Duraisamy Gopinath, Chandrasekharan Jayadev, Mounasamy Varatharaj
Department of Orthopaedics, K.G. Hospital and Postgraduate Medical Institute, Arts College Road, Coimbatore, Tamil Nadu, 641018, India.
VCU Medical Center Ambulatory Care Center, 417 North 11th Street, Richmond, VA, USA.
Eur J Orthop Surg Traumatol. 2016 Apr;26(3):231-45. doi: 10.1007/s00590-016-1749-z. Epub 2016 Feb 29.
Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors.
We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO.
ETO is an important tool in the revision surgeon's armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.
翻修全髋关节置换术是一项技术要求较高的手术，在过去二十多年里变得越来越重要。在大转子延长截骨术（ETO）出现之前的最初几年，它对翻修外科医生来说是一场噩梦。这项技术能够进入股骨髓腔而不损害骨量，并有助于在不进一步损伤母体骨的情况下取出初次植入物和骨水泥壳。与其他任何手术一样，正如各位作者所报道的，ETO确实存在某些局限性和并发症。尽管翻修外科医生经常使用它，但对ETO技术细节的全面了解仍然不足。因此，这篇综述文章旨在阐述多年来各位作者所介绍的ETO的适应证、手术步骤、固定技术、植入物选择和并发症。
我们在最常用的数据库如MEDLINE（PubMed）和谷歌学术中，使用适当的术语搜索有关翻修外科医生使用ETO的各种术前、术中和术后临床情况的文献。
ETO是翻修外科医生手术器械库中的一项重要工具，可用于各种临床情况以及满足各种术中和术后需求及目标。了解ETO的生物力学、适应证、植入物选择、固定技术和并发症对于良好的术中和术后结果至关重要。对于全球大多数翻修外科医生来说，后路ETO仍然是主要的手术方法。
