A. Pucher et al., The value of distal greater trochanteric transfer in the treatment of deformity of the proximal femur owing to avascular necrosis, J PED ORTH, 20(3), 2000, pp. 311-316
A series of 49 patients (55 hips) who had distal greater trochanteric trans
fer at the mean age of 13.9 years because of the deformity of the proximal
femur after treatment for developmental dislocation of the hip was reviewed
to verify the value of the procedure. Mean follow-up was 8.8 years. Clinic
al and radiologic assessment was supplemented with strain-gauging evaluatio
n of the muscles involved. Good results were achieved in patients who had g
ood range of movement or isolated restriction of abduction before the opera
tion. After surgery, a 22% increase of abductors torque was found, the Tren
delenburg sign disappeared in 30 individuals, and 15 patients regained norm
al gait. No complications were observed. Our study confirmed the value of d
istal transfer of the greater trochanter in treatment for proximal femur de
formity owing to avascular necrosis after management of developmental dislo
cation of the hip and clarified indications for this procedure.