Question:My father just had surgery to revise a total hip he had done last year. The doctor has given him strict warnings not to put any weight on that leg just yet. He's also been told not to abduct his operated leg. Dad's pretty cantakerous. He's likely to do it anyway. What can happen if he doesn't follow orders?
Answer:It sounds like your father has been given instructions called trochanteric precautions. These precautions include no active hip abduction and no weight on the affected leg for six weeks.
Such precautions are advised when a patient has had a trochanteric osteotomy as part of the revision operation. In this procedure, the outside edge of the femur (thigh bone) is removed. A large knob of bone at the top called the trochanter is part of the bone that is cut off.
The surgeon performs this type of osteotomy to gain better access to the hip joint. It is reattached with wires or cables. The instructions given are to help prevent nonunion and/or migration (movement) of the bone fragment during the healing process.
Hip muscles that attach to the trochanter can exert a tremendous pull on the bone. Until it has healed and re-united with the main part of the bone, compressive, shear, and load forces can cause problems.
Your father must be given as much information as possible to insure compliance with these instructions. The successful outcome of surgery may depend on it. Early breakage of the fixation system with migration can cause chronic hip pain, a limp, and an unstable hip.Gregg J. Jarit, MD, et al. Fixation Systems of Greater Trochanteric Osteotomies: Biomechanical and Clinical Outcomes. In Journal of the American Academy of Orthopaedic Surgeons. October 2007. Vol. 15. No. 10. Pp. 614-624.
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