Surgical treatment of high-standing greater trochanter

Eleven patients with high-standing greater trochanter (13 joints) aged 13-3 6 years underwent surgery. Distal transfer of the greater trochanter (group T) was performed in 4 patients (5 joints) and lateral displacement osteoto my (group L) in 7 (8 joints). The average follow-up duration was 13.4 years in group T and 5.9 years in group L, Clinical results were evaluated by th e hip score according to Merle d'Aubigne. The mean hip score in group T was 13.4 points before operation and 15.4 points after operation, and in group L, 12.8 and 17.4 points, respectively. The postoperative clinical results of group L were significantly better than those of group T (P = 0.0494). In radiological evaluation, although the articulo-trochanteric distance (ATD) increased in both groups in group L it improved remarkably from 9.8 to 24. 3, indicating a large descending distance of the greater trochanter, The le ver arm ratio (LAR) did not change significantly in group T, but it decreas ed from 1.97 to 1.60 in group L (P = 0.004). This means that the lever arm of the abductors can certainly be extended by lateral displacement osteotom y, Lateral displacement osteotomy is the most effective procedure for high- standing greater trochanter.