Closure of the fascia
It is recommended to start proximally with a continuous suture of the fascia of gluteus maximus. This can be difficult as this fascia is very thin. The suture ends at the level of the tip of the greater trochanter. From here a second continuous suture, that continues to the distal end of the fascial incision, is inserted to close the remainder of the incision.
Pearl: Before the fascia is closed, it is recommended to repair the layers of the trochanteric bursa to prevent adhesion between the trochanter and the fascia.
Subcutaneous suture and closure of the skin are performed according to the surgeon's preference.