Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up,International Orthopaedics

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Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up
International Orthopaedics ( IF 2.0 ) Pub Date : 2022-08-23 , DOI: 10.1007/s00264-022-05538-3
Jing Tang ₁ , Tiemure Wu ₁ , Hongyi Shao ₁ , Yixin Zhou ₁

Affiliation

Background

Maintaining continuity of the greater trochanter and restoring abductor function are of paramount importance in primary and revision total hip arthroplasty. Failure to rigidly fix the greater trochanter can lead to failure. Because of the lack of reports on the clinical results of greater trochanter fixation with a claw plate and cable system, we aimed to analyze the indications for the use of such a system that produces the best clinical results.

Methods

We retrospectively studied 41 consecutive patients who had undergone primary or revision total hip arthroplasty at our institution between January 2004 and December 2014 using a claw plate and cable system to achieve stable fixation of the greater trochanter.

Results

The mean follow-up duration was ten years. The median Harris hip score improved from 47 points before surgery to 87 points after surgery (p < 0.01). Significant improvements were observed in the range of motion, hip function, and routine activity. Osseous and fibrous union occurred in all patients, and one patient had severe complications (sciatica). Based on the Beals and Tower classification, 67%, 21%, and 13% of outcomes were considered excellent, good, and poor, respectively.

Conclusions

Our data support the use of a claw plate and cable system for greater trochanter fixation in complex primary and revision hip arthroplasty. The system showed promising results in patients with floating greater trochanters, intertrochanteric fractures requiring extra devices to maintain rotational stability, and extended trochanteric osteotomy fragments with a weakened proximodistal junction. The use of this system should be further investigated and compared to other methods.

中文翻译：

在复杂的初次和翻修全髋关节置换术中用爪板和电缆系统固定大转子：长期随访

背景

保持大转子的连续性和恢复外展肌功能在初次和翻修全髋关节置换术中至关重要。未能严格固定大转子可能导致失败。由于缺乏关于使用爪板和电缆系统固定大转子的临床结果的报告，我们旨在分析使用这种产生最佳临床结果的系统的适应症。

方法

我们回顾性研究了 2004 年 1 月至 2014 年 12 月期间在我们机构接受初次或翻修全髋关节置换术的 41 名连续患者，这些患者使用爪板和电缆系统实现了大转子的稳定固定。

结果

平均随访时间为十年。Harris 髋关节评分中位数从术前的 47 分提高到术后的 87 分（p < 0.01）。在运动范围、髋关节功能和日常活动方面观察到显着改善。所有患者均发生骨和纤维愈合，1 例患者出现严重并发症（坐骨神经痛）。根据 Beals 和 Tower 分类，分别有 67%、21% 和 13% 的结果被认为是优秀、良好和差。