PMC5949174_01
Preoperative radiograph showing osteoarthritis secondary to developmental dysplasia of the hips.
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Plain radiography indicated osteoarthritic changes, represented by hip joint narrowing, osteosclerotic changes in the subchondral bone, and osteophyte formation (Figure 1).
Preoperative magnetic resonance imaging. No abnormal findings are observed.
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However, preoperative magnetic resonance imaging did not show any abnormal findings of the gluteus medius muscle (Figure 2).
The patient underwent BS-THA via a posterolateral approach, which was successful without intraoperative complications.
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Postoperative radiographic evaluation demonstrated that the patient's right and left limbs were extended by 14 and 8 mm, respectively, when compared with the preoperative length (Figure 3).
Measurement of the preoperative and postoperative distance from the anterior superior iliac spine to the greater trochanter tip by using the ZedHip system. (a) Preoperative, right. (b) Postoperative, right. (c) Preoperative, left. (d) Postoperative, left.
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Lexi Co. Ltd., Tokyo, Japan) (Figure 4).
On the 14th postoperative day, the patient complained of left coxalgia during a walking exercise without any falls. Plain radiographs revealed a left greater trochanteric avulsion fracture.
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Plain radiographs revealed a left greater trochanteric avulsion fracture (Figure 5).
The fracture was fixed using tension band wiring on the 18th postoperative day.
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This fracture was fixed using tension band wiring on the 18th postoperative day (Figure 6).
On the 20th postoperative day, right coxalgia emerged during a transfer exercise. The greater trochanteric avulsion fracture on the right side was detected on plain radiographs.
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On the 20th postoperative day, right coxalgia occurred during a transfer exercise, and a greater trochanteric avulsion fracture on the right side was detected on plain radiographs (Figure 7).
On the 27th postoperative day, the right fracture was treated with small plate and wiring.
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On the 27th postoperative day, her right fracture was treated with small plate and wiring (Figure 8).
At the 18th postoperative month, the right fragment showed slight upper migration.
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The Harris Hip Score was 89/89 (Rt/Lt) points with range of motion of 10  bilateral adduction (Figure 9).