Archives of Basic and Clinical Research
Original Article

Optimal Level for Subtrochanteric Femoral Shortening Osteotomy in Crowe Type 4 Patients


Department of Orthopedics and Traumatology, VM Medical Park Maltepe Hospital, İstanbul, Türkiye


Department of Orthopedics and Traumatology, İstanbul Surgery Hospital, İstanbul, Türkiye


Department of Orthopedics and Traumatology, Arnavutköy State Hospital, İstanbul, Türkiye


Department of Orthopedics and Traumatology, Van Akdamar Hospital, Van, Türkiye


Department of Orthopedics and Traumatology, Health Science University Baltalimanı Bone Diseases Education and Research Hospital, İstanbul, Türkiye

Arch Basic Clin Res 2023; 5: 256-262
DOI: 10.5152/ABCR.2023.22085
Read: 801 Downloads: 415 Published: 01 May 2023

Objective: To investigate the optimal level for femoral shortening osteotomy in patients with dislocated hips undergoing total hip arthroplasty (THA) and make recommendations to avoid union problems.

Methods: We retrospectively reviewed 65 hips of 55 patients who underwent total hip arthroplasty for Crowe type IV developmental dysplasia of the hip. Osteotomy level is defined as the distance between the lesser trochanter and osteotomy line. The role of osteotomy level and osteotomy level-stem end distance on non-union rates, radiological union time, unsupported loading time, and Harris Hip Scores were investigated with Pearson correlation analyses.

Results: The mean follow-up period was 75.9 ± 32.0 months. The mean radiological union time was 6.5 ± 2.9 months. There was a positive and linear correlation between osteotomy level and radiological union time (r=0.385; P=.003). Harris Hip Scores were not correlated with osteotomy level (P=.503). The osteotomy performed at a distance of more than 30 mm had higher radiological union times (P=.002).

Conclusion: According to the results of the current study, the optimal osteotomy level should be within the 20-30 mm range from the lesser trochanter. Early revision should be avoided for patients with union problems. To prevent non-union, the cable should be well controlled so as not to enter into the osteotomy line.

Cite this article as: Alpay Y, Albayrak K, Ezici A, Kürk MB, Akbulut D, Gürsu S. Optimal level for subtrochanteric femoral shortening osteotomy in crowe type 4 patients. Arch Basic Clin Res., 2023;5(2):256-262.

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