Executive Editor: Joseph Schatzker, Peter Trafton

Authors: Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken

Proximal femur

Overview

Lateral approach i

Lateral approach

The lateral approach is used for insertion of a sliding hip screw or multiple screws after closed reduction of a proximal femoral fracture. The incision can be extended proximally to accommodate a trochanteric stabilizing plate.

Nailing approach i

Nailing approach

IM nails for trochanteric fractures enter through the top of the greater trochanter. However, the precise entry point in the greater trochanter depends on the design of the nail.

Posterolateral approach i

The posterolateral approach can be used for hip arthroplasty.

Anterolateral approach i

The anterolateral approach (Watson-Jones) provides somewhat limited access to the hip joint along with the lateral proximal femur and can be used for open reduction of displaced femoral neck fractures, and some femoral head fractures. 

Iliofemoral approach i

The anterior approach (iliofemoral or Smith-Peterson) provides the most direct access to the anterior aspect of the hip.

The anterior approach (iliofemoral or Smith-Peterson) provides the most direct access to the anterior aspect of the hip.

Direct lateral approach i

Make a longitudinal incision through skin and subcutaneous tissue, with its proximal end directed slightly posteriorly.

The direct lateral approach, usually done with the patient in lateral decubitus position, is excellent for hemiarthroplasty or uncomplicated primary total hip arthroplasty, and can be also be used for some femoral head fractures.

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v2.0 2010-11-14