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Trochanteric Non Union

- Discussion:
    - trochanteric non union is thought to occur in 2-15% of cases (following trochanteric osteotomy);
    - most trachanters that heal by osseous union do so within 3 months;
         - between 3 and 6 months, they are considered delayed union;
         - beyond 6 months a non union exists;
    - factors contributing to non union, include osteopenia of the greater trochanter, the proximal femur, or both;
         - patients who have had previous radiation exposure for HO or patients w/ DDH are at especially high risk for non union;
    - if trochanter is displaced distally 5 to 10 mm or replaced anatomically union may take 6 months;
    - highest incidence of nonunions occur with a supermedial tilt of trochanter, which can resulted in distal end separating from femur;
    - trochanteric non union may do well after wire fixation may do well after wire removal or may require reapproximation;
    - consequences of non-union:
         - dislocation
                - impaired abductor strength, limp, increased pain, and increased risk of dislocation;
                - risk of dislocation is approximately 10 fold higher (up to 20%) with trochanteric non union

Dislocation After Revision Total Hip Arthroplasty: an Analysis of Risk Factors and Treatment Options.

Reattachment of the Ununited Greater Trochanter Following Total Hip Arthroplasty. The Use of a Trochanteric Claw Plate.

Trochanteric non-union--does it influence the rate of revision following primary total hip replacement? A minimum of 15 years follow-up.

Reattachment of the ununited greater trochanter following total hip arthroplasty.

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