The bernese intertrochanteric osteotomy for femoral shortening

Summary

Objectives

Correction of leg length discrepancy through an intertrochanteric shortening osteotomy.

Indications

Leg length discrepancy up to 6 cm, on the condition that the shortening involves mostly the femur.

Contraindications

None.

Surgical Technique

The resection osteotomy of the proximal femur involves only the lateral and anterior cortex, the medial and posterior cortices remain attached to the proximal fragment. This allows to spare the insertion of the gluteus maximus muscle into the posterior cortex as well as the medial femoral circumflex artery. After shortening the osteotomy is firmly stabilized with an intertrochanteric osteotomy blade-plate.

Results

Between January 1982 and December 1997 we performed 10 intertrochanteric shortening osteotomies to correct leg length discrepancies ranging from 2.5 to 6.5 cm. The etiology of the leg length discrepancy was posttraumatic in 6 patients, a previously treated hip dysplasia in 3 and a bone loss after tumor resection at the proximal femur in 1 patient.

There were 4 women and 6 men with an average age of 25 years. All osteotomies consolidated without complications after 6 weeks and all patients were able to wear full weight after 8 weeks. A satisfactory active control of knee function was observed in all patients already after 4 weeks.