Ismailidis Petros, Mündermann Annegret, Stoffel Karl
Department of Orthopaedics and Traumatology, University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
Department of Clinical Research, University of Basel, 4031 Basel, Switzerland.
J Clin Med. 2023 Apr 18;12(8):2947. doi: 10.3390/jcm12082947.
Extended trochanteric osteotomy (ETO) is an established method in revision total hip arthroplasty. Proximal migration of the greater trochanter fragment and the resulting non-union of the osteotomy remains a major problem, and several techniques have been developed to prevent its occurrence. This paper describes a novel modification of the original surgical technique in which a single monocortical screw is placed distally to one of the cerclages used for the fixation of the ETO. The contact between the screw and the cerclage counteracts the forces applied on the greater trochanter fragment and prevents trochanteric escape under the cerclage. The technique is simple and minimally invasive, does not require special skills or additional resources, or add to surgical trauma or operating time, and therefore represents a simple solution to a complicated problem.
大转子延长截骨术（ETO）是翻修全髋关节置换术中一种成熟的方法。大转子碎片的近端移位以及由此导致的截骨不愈合仍然是一个主要问题，并且已经开发了几种技术来防止其发生。本文描述了对原始手术技术的一种新颖改良，即在用于固定ETO的其中一个环扎带的远端放置一枚单皮质螺钉。螺钉与环扎带之间的接触抵消了施加在大转子碎片上的力，并防止大转子在环扎带下移位。该技术简单且微创，不需要特殊技能或额外资源，也不会增加手术创伤或手术时间，因此是解决复杂问题的一个简单方法。
