- Discussion:
- trochanteric non union is thought to occur in 2-15% of cases (following trochanteric osteotomy);
- most trachanters that heal by osseous union do so within 3 months;
- between 3 and 6 months, they are considered delayed union;
- beyond 6 months a non union exists;
- factors contributing to non union, include osteopenia of the greater trochanter, the proximal femur, or both;
- patients who have had previous radiation exposure for HO or patients w/ DDH are at especially high risk for non union;
- if trochanter is displaced distally 5 to 10 mm or replaced anatomically union may take 6 months;
- highest incidence of nonunions occur with a supermedial tilt of trochanter, which can resulted in distal end separating from femur;
- trochanteric non union may do well after wire fixation may do well after wire removal or may require reapproximation;
- consequences of non-union:
- dislocation
- impaired abductor strength, limp, increased pain, and increased risk of dislocation;
- risk of dislocation is approximately 10 fold higher (up to 20%) with trochanteric non union
Dislocation After Revision Total Hip Arthroplasty: an Analysis of Risk Factors and Treatment Options.
Reattachment of the ununited greater trochanter following total hip arthroplasty.