Technique Tip : Modified Extended Trochanteric Osteotomy

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TECHNIQUE TIP: MODIFIED EXTENDED TROCHANTERIC OSTEOTOMY
Abstract:

Trochanteric osteotomy, the most extensile of approaches is a valuable tool for difficult primary and revision THAs. Extended trochanteric osteotomy is helpful in revision and extraction of well fixed cemented as well as uncemented fremoral components, facilitates in cement extraction and also in enhancing acetabular exposure. Tradional posterolateral ETO is initiated at the posterior aspect of the Femur.
We describe a modification of ETO by an anterolateral approach. The advantage of this approach is that as it preserves an intact musculo-osseo-muscular sleeve comprising of (gluteus medius and minimus, Greater Trochanter & vastus lateralis) it allows physiological reconstruction of hip’s soft tissue envelope and thus prevents proximal migration, nonunion of the osteotomy & abductor lurch, which are the commonest complications associated with an extended trochanteric osteotomy.
Anterolateral exposure of hip joint and anterior fibres of gluteus medius,minimus and capsule reflected as 1 cuff.2 limbs of osteotomy are marked and after completing the osteotomy with the help of osteotomes passed from posterior to anterior, the fragment is hooked open on its anterior muscular hinge. Osteotomy is fixed with the help of3-4 cerclage wires depending on length of osteotomy. Full weight bearing and abduction against gravity are only allowed after confirming

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