Abstract
Introduction
Trochanteric bursitis is described as pain over the lateral side of the hip and thigh. The usual treatment is rest, administration of NSAIDs and injection of local anaesthetic and corticosteroid. Occasionally it is resistant to these measures.
Background
Whilst performing an ablation of the trochanteric bursa we noticed that the fascia lata looked particularly tight. Therefore a z-plasty of the fascia lata was performed.
Methods
Patients were identified from the senior author's logbook. Retrospective case note review and telephone interview study was performed. All patients who have undergone this procedure between October 2004 and September 2006 are included. They had all failed a regime of 8/52 physiotherapy and NSAID followed by x3 injections 8/52 apart.
The visual analogue pain scoring system was used to assess all the patients post-operatively. Complete resolution of pain was seen as an excellent result. A score of 1-2 was regarded as good, and 3 or above as poor. All were followed up in the outpatients until they had returned to normal function.
Results
We present 15 patients with a mean follow-up of 14 (4-27) months. Mean age 50 (18-76). 10 were women. All were unilateral. 13 excellent and 2 good results. All returned to normal function. There was 1 superficial infection. No patients had a snapping IT band.
Discussion
Trochanteric bursitis is a common condition with an incidence in primary care of as 1.8 patients per 1000 per year. It is more common in females (80%).
Trochanteric bursitis is commonly due to repetitive trauma with repetitive irritation of the bursa by the fascia lata during walking. Therefore by elongating the fascia lata slightly you can prevent this repetitive trauma.
Conclusion
Z-plasty of the fascia lata is a procedure that can be used for the treatment of intractable trochanteric bursitis.
