Trendelenburg gait and its treatment by trochanteric advancement

Objectives: To evaluate the clinical and radiographic correction obtained by trochanteric advancement in patients with Trendelenburg gait due to avascular necrosis of the femoral head following treatment of developmental dysplasia of the hip or septic arthritis. Methods: Results of distal and lateral advancement of the greater trochanter were evaluated in 16 hips of 12 patients (6 boys, 6 girls; mean age 11 years 8 months; range 7.5 to 18 years) with Trendelenburg gait secondary to the relative overgrowth of the greater trochanter because of avascular necrosis of the femoral head. The deformity was bilateral in four and unilateral in eight patients. Etiology was developmental dysplasia of the hip in 13 hips of 10 patients, and septic arthritis in three hips of two patients. The mean follow-up period was three years and two months (range 1 to 7 years). Results: All patients showed both clinical and radiographic improvement postoperatively. The Trendelenburg sign, which was positive in all patients preoperatively, became delayed positive in six hips of four patients. The results were excellent in eight hips, good in five hips, and fair in three hips. Conclusion: Trochanteric advancement results in satisfactory clinical results in patients with Trendelenburg gait.

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