Application of a Fork Plate for Greater Trochanter Osteosynthesis in Total Hip Arthroplasty

Abstract

The aim of the study was to assess the effectiveness of using an original technique of greater trochanter fragment fixation during total hip replacement.

Materials and Methods

Since 2013, this construction has been implanted in 175 patients in the clinic of the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden. By the present time, 50 patients have been examined in order to assess the effectiveness of this construction. They were divided into three groups depending on the cause of greater trochanter fixation by the original plate: osteotomy according to T. Paavilainen, periprosthetic Vancouver type AG fractures, false joints of the greater trochanter. The degree of consolidation of the greater trochanter fragment with the femoral bone metadiaphysis was assessed using the roentgenometric technique according to M. Hamadouche’s recommendations. The functional result of the hip was evaluated according to the Oxford Hip Score scale.

Results

The nonunion rate in the presented groups was 8.3% in fragment fixation after osteotomy according to T. Paavilainen, 25% after fragment fixation in periprosthetic Vancouver type AG fracture, and 11.1% in fixation of the greater trochanter fragment when treating a false joint of the given localization.

Conclusion

Preliminary results of the greater trochanter fixation using the original fork plate during total hip replacement showed sufficient effectiveness not only in osteotomies of the greater trochanter, periprosthetic iatrogenic and pathological Vancouver type AG fractures but also in case of false joints of this localization developed due to the failure of the previous fixation.