The lesser trochanter as a cause of hip impingement: pathophysiology and treatment options

Ganz, Reinhold; Slongo, Theddy; Turchetto, Luigino; Massè, Alessandro; Whitehead, David; Leunig, Michael (2013). The lesser trochanter as a cause of hip impingement: pathophysiology and treatment options. Hip International, 23(Suppl. 9), S35-S41. Wichtig Editore 10.5301/hipint.5000063

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Impingement of the lesser trochanter on the ischium or the posterior acetabular rim is not a frequent pathology, but has recently received increased recognition. We have seen 14 cases over a period of 14 years, but concentrate on eight hips showing complex deformities revealing similar characteristics. All eight hips had a residual Perthes or a Perthes-like disease with an elliptically deformed femoral head, but a congurent joint a short or absent femoral neck, a high riding greater trochanter, and a reduced vertical distance between the head and the lesser trochanter. Impingement took place between the lesser trochanter and the ischium or the posteroinferior acetabular border, but was hardly recognisable due to the predominant intraarticular impingement of the nonspherical femoral head and the extraarticular impingement of the greater trochanter. In three cases the impingement showed reproducible subluxation of the hip. While in our hips, excision was the preferred treatment for impingement due to an oversized lesser trochanter, distal advancement was used in the hips with the Perthes morphology; the surgical time was not longer. The overall clinical results in this group however were dominated by a substantial increase in the range of motion (ROM), dependent mainly on the achieved contour of the femoral head and the relative lengthening of the neck. Strength of active hip flexion was normal. Recurrent subluxation disappeared and no complications were recorded.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Ganz, Reinhold; Slongo, Theddy and Leunig, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1120-7000

Publisher:

Wichtig Editore

Language:

English

Submitter:

Christoph Steffen

Date Deposited:

02 Apr 2014 14:55

Last Modified:

15 Oct 2017 04:38

Publisher DOI:

10.5301/hipint.5000063

PubMed ID:

24062218

BORIS DOI:

10.7892/boris.41545

URI:

https://boris.unibe.ch/id/eprint/41545

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