Distal transfer of the greater trochanter

Abstract

After congenital dislocation of the hip, Perthes' disease and some other conditions, the femoral neck may be short and the greater trochanter in a relatively proximal position. Distal transfer of the greater trochanter is an effective and relatively simple operation to correct this deformity. We have reviewed 26 patients (27 hips) at a mean follow-up of eight years. Pain relief and improvement

Trochanteric Advancement in Patients with Legg-Calvé-Perthes Disease Does Not Improve Pain or Limp

“…Our results suggest the operation does not necessarily improve clinical symptoms and signs related to ROGT, as assessed by instrumented gait analysis and by clinical outcome measures. Two factors have been suggested to increase the incidence of poor results after greater trochanteric transfer: primary conditions such as infantile septic arthritis and DDH and the number of surgeries performed before transfer [11,14,15]. The association of these factors with poor results could most likely be the result of the onset of the disorder at an earlier age, resulting in a longer period of abnormal growth of the hip and greater need for surgical correction of the deformity and a prolonged rehabilitation period.…”

“…Earlier studies indicate trochanteric advancement is an effective treatment for ROGT, which resulted from many children's hip diseases [4,5,11,15,20,23]. However, these studies included patients with different etiologies and severities of diseases and report results as an outcome from one or multiple operative techniques.…”

Intertrochanteric osteotomy in young adults for sequelae of Legg-Calv�-Perthes? disease?a long term follow-up

“…The femoral head can be adjusted using an intertrochanteric osteotomy [10,12,17,18,19]or advancement of the greater trochanter [9]or both [7,13]. Options for treatment on the acetabular side are Salter-type osteotomies [13,25], rotational acetabular osteotomies [6,8,15,22,26] and augmentation procedures like acetabular roof plasty [11,13,16,24].…”

“…A valgus osteotomy was the most used procedure. Not only did it improve congruency, it also has the advantage that leg-length discrepancy, hinging and impingement can be addressed [3,4,9,13,17,20]. In cases where the abduction forces needed addressing, even after a valgus osteotomy, the possibility of an advancement of the greater trochanter was chosen [7,13].…”

Current concepts and trends for operative treatment of FAI: hip arthroscopy

“…The greater trochanter can also impinge against the pelvis and is classically seen in the setting of Legge Calve Perthes disease, with coxa breva, vara, and a prominent greater trochanter [15,16]. More subtle cases of trochanteric-pelvic impingement are being described and typically present with motion limitations that are greater than expected based on the pathomorphology seen on plain radiographs and lack of relief with intra-articular anesthetic injections.…”