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The role of trochanteric flip osteotomy in fixation of certain acetabular fractures

PURPOSE: Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in pos...

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Autores principales: Gupta, Sandeep, Singh, Jagdeep, Virk, Jagandeep Singh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473740/
https://www.ncbi.nlm.nih.gov/pubmed/28526613
http://dx.doi.org/10.1016/j.cjtee.2016.11.006
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author Gupta, Sandeep
Singh, Jagdeep
Virk, Jagandeep Singh
author_facet Gupta, Sandeep
Singh, Jagdeep
Virk, Jagandeep Singh
author_sort Gupta, Sandeep
collection PubMed
description PURPOSE: Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. METHODS: From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher–Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. RESULTS: Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. CONCLUSION: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way.
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spelling pubmed-54737402017-06-26 The role of trochanteric flip osteotomy in fixation of certain acetabular fractures Gupta, Sandeep Singh, Jagdeep Virk, Jagandeep Singh Chin J Traumatol Original Article PURPOSE: Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. METHODS: From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher–Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. RESULTS: Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. CONCLUSION: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way. Elsevier 2017-06 2017-03-23 /pmc/articles/PMC5473740/ /pubmed/28526613 http://dx.doi.org/10.1016/j.cjtee.2016.11.006 Text en © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Gupta, Sandeep
Singh, Jagdeep
Virk, Jagandeep Singh
The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title_full The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title_fullStr The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title_full_unstemmed The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title_short The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
title_sort role of trochanteric flip osteotomy in fixation of certain acetabular fractures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473740/
https://www.ncbi.nlm.nih.gov/pubmed/28526613
http://dx.doi.org/10.1016/j.cjtee.2016.11.006
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