Transverse Femoral Osteotomy for Revision Surgery- an Alternative to the Transfemoral Approach
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Volkrnar Jansson 1, Peter E. MLiller 1, Christoph Pellengahr 2
- چاپ و سال / کشور: 2002
Description
Objective Exchange of a loosened femoral component in the presence of large proximal bone defects which require a distal anchorage of the revision stem. Indications Removal of remaining cement fragments from distal femur. Extraction of broken part(s) of femoral component. Marked anterior bowing of femoral shaft before insertion of revision stem. Contraindications Severe osteopenia of the femoral shaft. Infection. Poor general health. Surgical Technique Removal of femoral component. Transverse femoral osteotomy at least 12 cm distal to the tip of the greater trochanter. Removal of remaining cement from distal and proximal fragments. Conical reaming of distal femur. If necessary, prophylactic wire cerclage of distal fragment. Insertion of revision stem through the proximal fragment and impaction into the distal fragment. Packing of the defect of the proximal fragment with corticocancellous bone grafts to increase stability. Results Assessment of twelve patients (eight women, four men, average age at surgery 70 years and I month). Average length of follow-up 2 years and 11 months (I year, 9 months to 5 years, 1o months). Average Harris hip score 8o.2 points. Merle d'Aubign~ score: four excellent, one good, two satisfactory, four acceptable, and one poor result. A sufficient bony bridging of the osteotomy gap was seen radiologically in all patients.
Orthopedics and Traumatology
