O1334 REATTACHMENT OF THE UNUNITED GREATER TROCHANTER FOLLOWING TOTAL HIP ARTHROPLASTY: THE USE OF A TROCHANTERIC CLAW PLATE

Abstract

Aims: The purpose of this retrospective study was to report on the treatment of migrated ununited greater trochanter following total hip arthroplasty. Methods: Between January 1986 and December 1999, 72 non-unions of the greater trochanter in 71 patients were treated using a trochanteric claw plate. The mean age of the patients was 66 ± 11 years. The average time to re-operation was 8 months. Fixation of the non-united greater trochanter was performed using a claw plate only in 47 hips, and the association of frontal wires with a claw plate in the remaining 25 hips. The main criterion for evaluation was the consolidation of the greater trochanter judged as follows: bony consolidation (no pain, no Trendelenboug gait, radiologic fusion); fibrous consolidation (moderate pain, no Trendelenboug gait, radiologic fusion difficult to assess); and non-union (Trendelenboug gait and/or absence of radiologic fusion). Results: The average follow-up of the series was 4 years (1 to 14 years). The mean d’Aubigné score significantly increased from 13.5 preoperatively to 15.9 at last follow-up (paired signs test, p < 0.0001). Bony consolidation was obtained in 51 hips, fibrous in 9, whereas repeat non-union occurred in 12. The only predictive factor for union was the use frontal wires in association with a claw plate that provided 87.5% of unions and no failure (Chi square test, p = 0.006). Conclusions: This study indicated that non-union of the greater trochanter following total hip arthroplasty can be successfully treated with frontal wires in conjunction with a trochanteric claw plate.