Direct complications of trochanteric osteotomy in open reduction and internal fixation of acetabular fractures.

Osteotomy of the greater trochanter has been used to enhance exposure, especially the dome, in posterior and lateral exposures of the acetabulum. In 55 patients, osteotomy of the greater trochanter was performed in connection with open reduction and internal fixation of a displaced acetabular fracture. The trochanter was reattached by screw fixation. One osteotomy resulted in nonunion, and 2 cases showed partial avulsion or migration of the trochanter. Eleven of the 55 patients (20%) required screw removal from the trochanter. Five patients developed complete ankylosis from heterotopic ossification despite indomethacin prophylaxis; 1 young man underwent excision. Since this procedure increases the complications of fracture management, the inherent risk-to-benefit ratio should be evaluated in each patient.