PROXIMAL VERSUS DISTAL LENGTHENING OF THE FASCIA LATA IN THE TREATMENT OF TROCHANTERIC BURSITIS

Abstract

Introduction: Trochanteric bursitis rarely needs surgical treatment. A distal lengthening procedure has been described.

Purpose: To analyze the outcomes of two different surgical techniques: proximal and distal lengthening of the fascia lata.

Materials and methods: Median instead of average was used for the quantitative variables. Twenty one patients (23 hips) were treated between October 1999 and February 2006. They were divided into two groups and their previous medical and surgical history was collected. The proximal Z-plasty group included 10 hips with a median age of 54 years; median body mass index (BMI) was 28.5 and median time from onset of symptoms till surgery was 36 months. The distal Z-plasty group included 13 hips, median age was 54.6 years; median BMI was 26.3; and evolution till surgery was 18 months. Harris hip score, verbal analog scale for pain (VAS) and a Lickert satisfaction scale were used.

Results: In the “proximal group” the Harris hip score improved from 61 to 77.5. VAS improved from 82.5 to 27.5 and as regards the Lickert score 3 hips were very satisfied; three were satisfied; two hardly satisfied; one dissatisfied and one very dissatisfied. Two seromas occurred after surgery. In the “distal group” Harris score improved from 63 to 91. VAS improved from 90 to 10 and the Lickert scale gave 5 very satisfied hips; 4 satisfied; none hardly satisfied; 4 dissatisfied and none was very dissatisfied. There was a seroma after surgery.

Conclusion: Despite the low number of cases, distal Z- plasty showed better results than the proximal technique in the treatment of trochanteric bursitis.