The migrated painful ununited trochanter following total hip replacement
can provoke a significant degree of functional disability. Although this
condition is infrequently observed after total hip replacement, its
occurrence causes definite problems for its operative management. A
technique employing the trochanteric bolt for reattachment of the migrated
painful trochanteric fragment is described. The results of this approach in
five patients to date are relief from pain and decreased disability in all
five. The factors promoting migration of the osteotomized fragment include
the quality of the trochanteric bone, the stresses placed on the osteotomy
site by the patient during the postoperative period, and the precise method
of reattachment of the trochanter at the time of total hip replacement.