Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

The bernese intertrochanteric osteotomy for femoral shortening

Summary

Objectives

Correction of leg length discrepancy through an intertrochanteric shortening osteotomy.

Indications

Leg length discrepancy up to 6 cm, on the condition that the shortening involves mostly the femur.

Contraindications

None.

Surgical Technique

The resection osteotomy of the proximal femur involves only the lateral and anterior cortex, the medial and posterior cortices remain attached to the proximal fragment. This allows to spare the insertion of the gluteus maximus muscle into the posterior cortex as well as the medial femoral circumflex artery. After shortening the osteotomy is firmly stabilized with an intertrochanteric osteotomy blade-plate.

Results

Between January 1982 and December 1997 we performed 10 intertrochanteric shortening osteotomies to correct leg length discrepancies ranging from 2.5 to 6.5 cm. The etiology of the leg length discrepancy was posttraumatic in 6 patients, a previously treated hip dysplasia in 3 and a bone loss after tumor resection at the proximal femur in 1 patient.

There were 4 women and 6 men with an average age of 25 years. All osteotomies consolidated without complications after 6 weeks and all patients were able to wear full weight after 8 weeks. A satisfactory active control of knee function was observed in all patients already after 4 weeks.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Christie J, Robinson CM, Pell, AC. Transcardiac echocardiography during invasive intramedullary procedures. J Bone Joint Surg [Br] 1995;77:450–5.

  2. 2.

    Edwards K, Cummings R. Fat embolism as a complication of closed femoral shortening. J Pediatr Orthop 1992;12:542–3.

  3. 3.

    Ganz R. Die Trochanterversetzung bei adduzierender (varisierender) intertrochantärer Osteotomie. Operat Orthop Traumatol 1989;1:211–8.

  4. 4.

    Levy D. The fat embolism syndrome. Clin Orthop 1990;261:281–6.

  5. 5.

    Müller ME. Die Verkürzungsosteotomien. In: Müller ME, Hrsg. Die hüftnahen Osteotomien. Suttgart: Thieme, 1971;138–40, 197–8.

  6. 6.

    Müller ME. Planung einer komplexen intertrochanteren Osteotomie. Z Orthop 1979;117:145–8.

  7. 7.

    Müller, ME, Allgöwer M, Schneider H, et al. Manual of internal fixation. 3. Aufl. Berlin-Heidelberg-New York: Springer, 1991.

  8. 8.

    Pell A, Christie J, Keating JF. The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. J Bone Joint Surg [Br] 1993;75:921–5.

Download references

Author information

Correspondence to Ariane Gerber.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gerber, A., Ganz, R. The bernese intertrochanteric osteotomy for femoral shortening. Orthop Traumatol 8, 14–21 (2000). https://doi.org/10.1007/BF03181116

Download citation

Key Words

  • Intertrochanteric osteotomy
  • Leg length discrepancy
  • Bony shortening procedures