Effects of greater trochanteric osteotomy in the treatment of femoral head fractures combined with acetabular labral tear

Wang Haoran; Wang Han; Ji Zhengang; Han Tianyu; Liang Na

doi:10.3969/j.issn.1009-4237.2025.05.006

Abstract：Objective To investigate the clinical effect of greater trochanteric osteotomy in the treatment of femoral head fractures combined with acetabular labral tear.Methods From Jan.2014 to Dec.2023,31 such pa-tients admitted to Department of Orthopedics,General Hospital of Northern Theater Command,and treated by greater trochanteric osteotomy were included.There were 22 males and 9 females,aged 18-63(mean 38.7)years,with 17 cases on the right side and 14 on the left.The causes of injuries were falls from height in 14 cases and road traffic accidents in 17.All the injuries were confirmed preoperatively by X-ray and 3D CT scan.The Kocher-Langenbeck approach in lateral recumbent position was adopted to perform greater trochanter osteotomy,the femoral head fracture was reduced and fixed and the acetabular labrum tear was repaired.Joint function was evaluated according to the Tompson-Epstein scoring system during follow-up.Results According to the Pipkin fracture classification,there were 15 cases of type Ⅰ,12 type Ⅱ and 4 type Ⅲ.The types of labial tears were 9 cases of longitudinal peripheral avulsion,8 longitudinal peripheral avulsion&posterior root avulsion,6 bone avulsion,and 8 bone avulsion&posteri-or root avulsion.All patients were followed up for 12-60 months,with an average of 39.2 months.All the cases ob-tained healing at the osteotomy site and all the acetabular tears were completely repaired.Joint function at last fol-low-up was excellent in 13 cases,good in 14,medium in 3,and poor in 1.Osteonecrosis of the femoral head was re-ported in 3 cases.Conclusion For femoral head fractures combined with acetabular labral tears,greater trochan-teric osteotomy is beneficial to protect blood supply,and the hip joint can be observed in an all-round way,which is convenient for the management of femoral head fractures and labral tears.The clinical outcomes are satisfactory.