For certian total hip-replacement operations osteotomy of the greater
trochanter is essential, and for others it is advantageous. A system of
management of trochanter reattachment is described that takes into account
multiple factors, such as the need to remove large or small amounts of the
trochanter depending on the patient's anatomy and on the style of the
femoral component used, the need in some cases to advance the trochanter to
lie against the cortex of the femur, the need in other instances to deal
with markedly porotic trochanters, and the fact that a small number of the
wires will fatigue, regardless of the technique used. The basic technique
has one horizontal and two separate vertical wires, all passing medial to
the femoral stem and each tied to itself in a square knot; All wires pass
through the trochanter to prevent rotation. Wire mesh is used
prophylactically if the trochanter is porotic. All patients use two
crutches for two months postoperatively; In a consecutive series of 136
total hip replacements in which the trochanter was reattached using this
technique, none of the trochanters migrated and all united.