The anterior approach provides the most direct access to the anterior aspect of the hip. Many surgeons prefer this approach for reduction of femoral head and neck fractures.
The anterolateral approach to the proximal femur, through the interval between the gluteus medius and minimus muscles and tensor fascia lata, provides access to the hip joint at the lateral proximal femur. This approach is adequate for fracture fixation and application of a plate onto the lateral aspect of the femur.
The transgluteal approach to the proximal femur, between the anterior and medial part of the gluteus medius, provides access to the hip joint at the lateral proximal femur.
This approach is adequate for fracture reduction with K-wire, screw or plate fixation and is indicated in the following situations:
- Open reduction and stabilization of extracapsular neck fractures
- Stabilization of nondisplaced but complete intracapsular fractures