Sliding trochanteric osteotomy in acetabular fractures: a review of 30 cases

OBJECTIVE: To assess the results of using sliding trochanteric osteotomy as an adjunct procedure for acetabular fractures. DESIGN: Retrospective review. SETTING: Level 1 trauma centre. METHODS: Thirty patients (19 men, 11 women, mean age 40 years, range 23-80 years) having fracture of acetabulum underwent sliding trochanteric osteotomy for a better exposure of the fracture involving the dome of acetabulum during the period January 1999-January 2004. MAIN OUTCOME MEASUREMENTS: Clinical evaluation was based on modified Merle d' Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council (MRC) grading system. Radiographic evaluation of the joint was also documented. RESULTS: All the osteotomies healed within 12 weeks without any proximal migration except for one patient with infection in whom nonunion occurred. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 2/5 in one patient, Grade 3/5 in one patient, Grade 4/5 in six patients and Grade 5/5 in the rest. Clinical scoring was excellent to good in 77%. Heterotopic ossification occurred in six patients and was of modified Brooker's classes 1 and 2. CONCLUSIONS: This technique can be relied upon to provide an adequate exposure of the dome of acetabulum without the associated complications like malunion, non-union, etc., known to occur with standard oblique osteotomy.