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Trochanteric osteotomy for acetabular fracture fixation: a case series and literature review

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

This study examined osteotomy union and heterotopic ossification (HO) after performing digastric trochanteric osteotomies during open reduction and internal fixation (ORIF) of acetabular and combined femoral head fractures. Femoral head osteonecrosis and trochanteric screw removal were secondarily assessed.

Methods

Twenty-six patients treated at a Level I trauma center, from years 2003 to 2019, who received a digastric trochanteric osteotomy during acetabular and combined femoral head fracture ORIF through a posterior surgical approach were retrospectively identified. Osteotomies were fixed with two 3.5 mm cortical lag screws. Rates of osteotomy union, HO, femoral head osteonecrosis, and trochanteric screw removal were determined.

Results

All osteotomies went onto union without displacement or failure of fixation. Only three (12%) patients developed severe HO (modified-Brooker class III–IV). There were no instances of femoral head osteonecrosis and only one (7%) patient required trochanteric screw removal.

Conclusions

The digastric trochanteric osteotomy heals reliably with low rates of severe HO, femoral head osteonecrosis, and screw removal for soft-tissue irritation. A review of the literature is presented and found comparable findings.

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Correspondence to Michael J. Chen.

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Conflict of interest

M.J.G. receives personal fees from Pacira Pharmaceuticals, Biocomposites, BoneSupport AB, Conventus, Globus Medical, StabilizOrtho, Synthes, and from KCI outside of the submitted work. None of the remaining authors have anything to disclose.

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Chen, M.J., Wadhwa, H., Tigchelaar, S.S. et al. Trochanteric osteotomy for acetabular fracture fixation: a case series and literature review. Eur J Orthop Surg Traumatol 31, 161–165 (2021). https://doi.org/10.1007/s00590-020-02753-9

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  • DOI: https://doi.org/10.1007/s00590-020-02753-9

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