Sandeep Gupta,Jagdeep Singh,Jagandeep Singh Virk.[J].Chin J Traumatol,2017,20(3):161-165. [doi]
The role of trochanteric flip osteotomy in fixation of certain acetabular fractures
  
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KeyWord: KochereLangenbeck approachAcetabular fracturesTrochanteric osteotomyPosterior wallSuperior dome
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Author NameAffiliation
Sandeep Gupta Department of Orthopaedics, Government Medical College and Hospital (GMCH), Chandigarh, India 
Jagdeep Singh Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital (GGSMCH), Faridkot, India 
Jagandeep Singh Virk Department of Orthopaedics, Government Medical College and Hospital (GMCH), Chandigarh, India 
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Abstract:
      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 KochereLangenbeck 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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