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Trochanteric-sparing Proximal Femoral Resection for Arthritic Spastic Hips

dc.contributor.authorBauer, Jennifer M.
dc.contributor.authorButler, Marjorie P.
dc.contributor.authorSchoenecker, Perry L.
dc.contributor.authorSchoenecker, Jonathan G.
dc.date.accessioned2019-02-04T20:23:35Z
dc.date.available2019-02-04T20:23:35Z
dc.date.issued2018
dc.identifier.citationBauer, J. M., Butler, M. P., Schoenecker, P. L., & Schoenecker, J. G. (2019). Trochanteric-sparing Proximal Femoral Resection for Arthritic Spastic Hips. Techniques in Orthopaedics, Publish Ahead of Print. https://doi.org/10.1097/BTO.0000000000000324en_US
dc.identifier.issn0885-9698
dc.identifier.other10.1097/BTO.0000000000000324
dc.identifier.urihttp://hdl.handle.net/1803/9375
dc.description.abstractProgressive hip subluxation or dislocation leading to degenerative disease, in neuromuscular disease, is a significant cause of morbidity to the patient and burden to the caretaker. Surgical salvage procedures have unpredictable success. We hypothesized that modifying the Castle-type proximal femoral resection by securing a retained greater trochanter with its musculature to the capsular arthroplasty and femoral shaft would compartmentalize the femur to decrease proximal femoral migration and heterotopic ossification (HO), thereby precluding the need for traction and HO prophylaxis while improving pain and caretaker satisfaction. The purpose of this report is to describe the novel trochanteric-sparing proximal femoral resection (TS-PFR) technique. Seventeen hips in 13 patients were treated by the TS-PFR procedure. Twelve of 13 patients experienced complete pain relief, and all had improved sitting tolerance and perineal care. These results represent an improvement from prior salvage operations, without increase in blood loss, length of stay, proximal femoral migration, or HO. One patient underwent revision for failed soft tissue envelope. A retrospective review of patients treated at 2 institutions identified those who underwent TS-PFR for arthritic spastic hip. Perioperative course, radiologic evaluation for migration and HO, and caretaker satisfaction were compared with prior published surgical techniques. The TS-PFR technique is a safe alternative to previously described spastic hip salvage procedures and may improve upon them by creating a compartment for the proximal femur that precludes the need for traction and decreases HO. The technique improves patients’ pain, sitting tolerance, perineal hygiene, and caretaker satisfaction.en_US
dc.language.isoen_USen_US
dc.subjectNeuromuscular Spastic Hipen_US
dc.subjectTrochanteric-Sparing Proximal Femoral Resectionen_US
dc.subjectCastle Resectionen_US
dc.subject.lcshOrthopaedicsen_US
dc.titleTrochanteric-sparing Proximal Femoral Resection for Arthritic Spastic Hipsen_US
dc.typeArticleen_US
dcterms.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/en_US


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