Surgical Discussion

Patient positioning:  Supine position on a radiolucent table to facilitate fluoroscopic imaging and access to the anterior aspect of the hip.

Anatomical surgical approach:  Modified anterior approach to the hip, involving an incision over the anterior superior iliac spine extending distally along the sartorius muscle. Dissection proceeded through the interval between the sartorius and tensor fascia lata, with careful protection of the lateral femoral cutaneous nerve. Capsulotomy was performed to expose the femoral head for fracture reduction and fixation.

Following successful reduction and fixation of the femoral head using 2.0 mm and 2.4 mm lag screws, an EUA was conducted to evaluate hip stability. The hip demonstrated stability, indicating that fixation of the acetabular rim fracture was not required. The decision to forego acetabular fixation was based on intraoperative stability findings.

Postoperative protocol:   Postoperative rehabilitation included protected weight-bearing with crutches for 6 weeks, followed by gradual progression to full weight-bearing as tolerated. Range of motion exercises were initiated early to prevent stiffness, with emphasis on avoiding excessive flexion and rotation during the initial healing phase.

Follow up:   Not specified.

Orthopaedic implants used:   2.0 mm and 2.4 mm lag screws.