Abductor Strengthening Subtrochanteric Femoral-shortening Osteotomy in High Developmental Dysplasia of the Hip

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Abstract

Subtrochanteric femoral-shortening osteotomy is frequently performed in high dislocation of the hips (Crowe type IV). These osteotomies are performed to restore the true center of hip rotation and prevent sciatic nerve stretch. Most of the osteotomies described in the literature are able to achieve effective shortening of the femur and restore center of hip rotation, but they do not address the issue of weak abduction and the possibility of nonunion at the osteotomy site. In the following description, a new form of osteotomy is described in which the tendon of the gluteus maximus is preserved and transposed laterally on to the shaft of the femur to enhance abduction strength and aid in early healing of the osteotomy.

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