Materials and techniques in trochanter reattachment

Abstract

A retrospective analysis was carried out to establish the breakage rates of the stainless steel wires used to reattach the osteotimosed greater trochanter during total hip replacement. The technique of wiring produced a significant difference in breakage rates, with the three-wire method failing in 61%, whereas the two-wire technique failed in 41% of cases. The use of a finer gauge wire made of a new stainless steel, Ortron 90, was associated with a greater rate of wire failure (52·6%) than occurred when the previously used, heavier gauge, CFT 100 wire was used (32·7%). Local discomfort occurred twice, and proximal shift of the greater trochanter three times more frequently if the wires had broken than if they had remained intact, and a greater degree of trochanter migration correlated directly with a higher incidence of a clinically detectable weakness of hip abduction. Care should be taken when selecting techniques and materials of reattachment to reduce the complications of trochanteric osteotomy.