Access to the peritrochanteric space affords the surgeon with access to pathology associated with the
greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rotators, iliopsoas tendon, and the gluteus medius and minimus tendon attachments.
Proximal femoral osteotomies have been used in the treatment of hip dysplasia for approximately a century with a varus osteotomy to correct the coax valga and a distal transfer of the
greater trochanter to correct for trochanteric overgrowth.
Under fluoroscopic monitoring, the entry point must be on top of the
greater trochanter in anteroposterior view and in line with the centre of the femoral canal in lateral view It was this correct entry-point location that took a large proportion of time and X-ray exposure during our operations.
Table 1 Background of the Patients with Femoral Trochanteric Fracture PFNA (N = 50) Age 63 to 94 years (mean, 84) Gender Male 5 (10%) Female 45 (90%) Type of fracture Al 25 (50%) A2 20 (40%) A3 5 (5%) Table 2 Intraoperative and Postoperative Complications in Patients with Femoral Trochanteric Fracture PFNA (N = 50) Superficial infection 0 (0%)
Greater trochanter fracture 1 (2%) Lateral sliding of the blade (> 10 mm) 4 (8%) Cut out 1 (2%) Diaphyseal fracture 1 (2%)
A t-test was used to compare differences in mean cortical thickness between the femoral head, femoral neck,
greater trochanter, intertrochanteric region, and subtrochanteric region between the osteoporotic proximal femur subjects.
In this study we attempted to find the per operative distance between tip of
greater trochanter and centre of femoral head clinically.
Though frank tendon tears and imaging findings of bursitis have been shown to correlate with symptoms of lateral hip pain, the finding of peritrochanteric edema alone, identified as increased T2-weighted signal but not a true fluid collection paralleling the
greater trochanter on axial or coronal MR images (Figure 10), does not correlate with hip pain.
Reference line design: In order to describe the mediolateral and superioinferior relationship between NEPs and the bony landmarks, the
greater trochanter of femur (A), lateral epicondyle of femur (B), and pubic tubercle (C) were chosen as bony landmarks for measurement.
Disadvantages are difficulty in obtaining a proper start point in obese patients, patients with hypertrophic short external rotators, or
greater trochanter overhang.
(a) Male, 6.5 years at initial diagnosis, osteosarcoma of distal femur, and femur length (
greater trochanter to eminentia intercondylaris) is 290 mm.