Gentle distraction of the joint may facilitate irrigation and visualization.
For arthroscopic removal, a fracture table is always used.
Note: For a detailed description, the reader is referred to the corresponding textbooks, or literature.
In an open procedure, "free-hand" distraction, or distraction using the fracture traction table is at the discretion of the surgeon.
The advantage of free-hand distraction is the ability to rotate the femoral head. However, the amount of distraction possible is less than when using a traction table.
In some specific cases (eg, large fragments, or a bigger defect on the femoral head), surgical hip dislocation can become necessary for removal of the fragment. Surgical hip dislocation also facilitates reattachment of the fragment, or corrective osteotomy to reorientate the intact part of the femoral head into a good loading position.