Ganz trochanteric flip surgery

Case contributed by Assoc Prof Craig Hacking

Presentation

Intra-articular bullet for operative removal

Patient Data

Age: 20-25 years
Gender: Male

CT scout

CT

This scout shows 4 oblique screws across the right greater trochanteric osteotomy.

4 screws traverse the greater trochanteric osteotomy. The osteotomy (Ganz procedure) was performed to dislocate the hip, enabling the surgeons to remove an intra-articular bullet post GSW.

Pre operative X-ray

X-ray

A metallic foreign body is projected within the medial hip joint on this single view. CT confirmed the intra-articular location of the bullet.

Case Discussion

A Ganz trochanteric flip is a surgical method for hip dislocation to gain access to the femoral head and acetabulum without risking avascular necrosis of the head. By performing an osteotomy of the greater trochanter and flipping it posteriorly, the hip adductors are preserved along with the blood supply to the femoral head, namely the deep branch of the medial circumflex femoral artery.

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