A new transtrochanteric approach to the hip.

This transtrochanteric approach to the hip maintains continuity between the greater trochanter and the vastus lateralis muscle, thereby preventing the gross displacement of the greater trochanter and preserving the branches of the lateral circumflex vessels to it. The procedure offers the advantages of easy exposure and a high rate of bony union between trochanter and femur. We have used the procedure in 189 consecutive operations; in only four cases did union between the bones not occur. The trochanter was never cranially displaced more than three cm, and even in the cases of non-union abductor power was good. Although we do not recommend trochanteric osteotomy for every case of total hip replacement, we suggest that the approach be used for cases where technical problems are anticipated.