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 lateral approach is indicated in the following situations:
- In combination with an anterior approach for the insertion of screws or a pediatric hip locking plate
- For the open and closed reduction and stabilization of extracapsular fractures
- For stabilization of nondisplaced intracapsular fractures
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
One great advantage of the ESIN for proximal femoral fractures is that the approach is minimally invasive of the soft tissues, facilitating early joint motion.