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Lateral via trochanteric flip

Gibson interval

The fascia lata is incised longitudinally and proximally from the most distal extent of the wound up to the greater trochanter.

The incision is continued along the anterior border of the gluteus maximus (Gibson approach).

The gluteus medius is visible proximal to the greater trochanter.

It is important to note that the gluteus maximus and tensor fascia lata have a combined fascial covering.

Dividing the fibers of the gluteus medius should be avoided and the interval between gluteus maximus and medius is best identified from within the incision made in the fascia lata.

Pearl: The assistant positioned next to the surgeon flexes the knee and extends the hip relaxing the gluteus maximus and its fascia. This improves the exposure of the posterior border of the gluteus medius.