Executive Editor: Fergal Monsell General Editor: Chris Colton

Authors: Andrew Howard, James Hunter, Theddy Slongo

Pediatric proximal femur

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Glossary

Lateral approach

Indications

The lateral approach is indicated in the following situations:

  1. In combination with an anterior approach for the insertion of screws or a pediatric hip locking plate
  2. For the open and closed reduction and stabilization of extracapsular fractures
  3. For stabilization of nondisplaced intracapsular fractures

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Skin incision

The incision should be placed so that the screws in the femoral neck are aligned with the axis of the neck.

If a plate is to be inserted, the incision will be prolonged distally and of sufficient length to allow adequate distal fixation.

Image intensification may be helpful for proper siting of the incision.


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Development

The fascia lata is incised in line with the incision. Having incised the origin of the vastus lateralis muscle with a longitudinal or L-shaped cut, the muscle is elevated from the femur.

Angular stable plates require sufficient distal extension of the incision to accommodate the drill guides and jigs.


Wound closure

The wound is closed in layers according to the surgeon's preference.

v1.0 2017-12-04