The purpose of this retrospective study was to analyze the utility of a
trochanteric claw plate in the treatment of an ununited greater trochanter
following total hip arthroplasty.
From 1986 through 1999, seventy-two consecutive procedures to reattach an
ununited greater trochanter were performed in seventy-one patients. The
average age at the time of the index arthroplasty was 66.2 years. The
arthroplasty that resulted in the nonunion of the greater trochanter was
primary in fifty-four hips, a first revision in sixteen hips, and a second and
third revision in one hip each. The mean duration between the hip replacement
and the treatment of the nonunion was 8.1 months. The greater trochanter was
fixed with the trochanteric plate alone in forty-eight hips and with the plate
in conjunction with vertical wires in the remaining twenty-four hips. The
average duration of followup was 5.1 years.
Osseous union occurred in fifty-one of the seventy-two hips. There was a
persistent nonunion in twelve hips and fibrous consolidation in the remaining
nine hips. The mean time to osseous consolidation was 3.7 ± 2.1 months
(range, two to twelve months). The mean Merle d'Aubigné hip score was
16.1 ± 2.4 points at the time of the latest follow-up. A highly
significant improvement in function was achieved only in the group with
osseous consolidation (p < 0.0001). The highest rate of osseous union was
achieved when vertical wires had been used in conjunction with the claw plate.
Union occurred in twenty-one of the twenty-four hips in that group (p =
Nonunion of the greater trochanter following total hip arthroplasty can be
successfully treated with a trochanteric claw plate. The use of adjunctive
vertical wires results in better osseous contact and union.