evaluation of the predictive value of the vertical distance of the greater trochanter tip from the teardrop line compared to the junction of the femoral head and neck in crowe classification for patients with developmental hip dislocation

Background: total hip arthroplasty (tha) in patients with developmental dysplasia of the hip (ddh) is challenging due to the severity of deformity and bone defects. this study aimed to evaluate the predictive value of using the tip of the greater trochanter as an alternative landmark in the crowe classification to indicate femoral osteotomy in patients with developmental dysplasia of the hip.methods: this retrospective study examined 39 patients with developmental dysplasia of the hip who underwent total hip arthroplasty from 2018 to 2023. based on radiographic assessments and surgical reports, five out of the six patients classified as crowe type iv underwent femoral osteotomy. in addition, among the eight patients classified as crowe type iii, four underwent osteotomy. based on the criterion of a greater trochanter height above 130%, nine out of nine patients required femoral osteotomy. the p-value for the greater trochanter height and all four crowe classification types was calculated.results: all patients classified as crowe types i and ii had a gt score below 130%. crowe type iii patients with gt scores above 130% underwent osteotomy, while those with gt scores below 130% did not. in crowe type iv patients, those with a gt score above 130% underwent osteotomy; only one patient in this group did not require osteotomy, and this patient had a gt score below 130%. there was a significant correlation between the gt score and each of the crowe classification types.conclusion: based on the results, the height of the greater trochanter can be used to predict whether femoral osteotomies should be performed during total hip arthroplasty in patients with developmental dysplasia of the hip.