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Similar to reduction of a chronic posterior hip dislocation using a Ganz trochanteric osteotomy
Similar to reduction of a chronic posterior hip dislocation using a Ganz trochanteric osteotomy (20)
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Recently uploaded (20)
reduction of a chronic posterior hip dislocation using a Ganz trochanteric osteotomy
- 1. Duane Anderson MD Soddo Christian Hospital, Ethiopia Lucas Anderson MD University of Utah Orthopaedics
- 2. Traditional approach/method External rotator sparing Preserve MFCA Difficult exposure scar filled acetabulum Dislocate anterior or work btw piriformis/abductor window (key hole exposure) Kocher
- 3. Traditional approach/method External rotator sparing Preserve MFCA Difficult exposure scar filled acetabulum Work btw external rotator/abductor window (key hole exposure) Capsulotomy vs capsulectomy when necessary Subtroch shortening osteotomy if too much tension Kocher
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- 14. 23M, 6mo Post-traumatic Posterior Hip Dislocation
- 15. Eureka: why not flip the troch and look down into empty tab?
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- 23. Straight lateral incision Flip trochanteric osteotomy Dissect capsular tissues/scar off ant neck Remove scar from TAL to labrum Capsulotomy vs capsulectomy Circumferential mobilization peri-acetabular tissues Evert the labrum (may need to section 3-4 places) Reduce hip +- Femoral shortening if difficult reduction 4.5mm Screws to refix trochanteric osteotomy, aim at lesser troch OPERATIVE STEPS
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- 26. ST. LUKE’S HEALTHCARE FOUNDATION AND SODDO CHRISTIAN HOSPITAL
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- 28. POD1
- 29. 6 Weeks Post Surgery
- 30. Mild hip pain Start: Partial WB Gentle motion F/u 4 wks 6 Weeks Postop
- 31. First 6wks: Touch down weightbearing Passive and then AAROM Second 6wks: Progress to 50% WB w aides AROM 3 mo: Progress to WBAT No running for 6 mo’s PostOp Protocol
- 32. Troch Flip Osteotomy gives powerful exposure to acetabulum and femoral head 1-1.5cm thick Digastric: vastus distal, abductors proximal Blood supply (MFCA) runs deep to Obturator Externus Remove scar starting at TAL/pulvinar Section Labrum to evert Learning Points
- 33. THANK YOU
Editor's Notes
- 25 yo m 5 months dislocated. 13 months post reduction and shortening osteotomy. Harris hope score 98.
- 25 yo m 5 months dislocated. 13 months post reduction and shortening osteotomy. Harris hope score 98.
- Healed, walking w/o aide and no pain at 6mo postop, HHS 98