Surgical Discussion

Patient positioning:  Supine position on a fracture table to facilitate access to the anterior aspect of the hip.

Anatomical surgical approach:  Anterior Heuter approach: A longitudinal incision was made over the anterior aspect of the hip, with careful dissection through the interval between the sartorius and tensor fascia lata muscles. The capsule was incised to expose the femoral neck and head for direct visualization and reduction of the fracture.

The surgeon emphasized the importance of achieving an anatomic reduction to mitigate the risks of avascular necrosis and nonunion. A fixed angle sliding hip screw (DHHS) was chosen over cannulated screws due to its mechanical advantages in maintaining reduction and providing stability in young patients with displaced femoral neck fractures.

Postoperative protocol:   Postoperative rehabilitation included early mobilization with toe-touch weight-bearing for 6 weeks, followed by progressive weight-bearing as tolerated. Range of motion exercises were initiated immediately post-surgery to prevent joint stiffness.

Follow up:   Not specified.

Orthopaedic implants used:   Dynamic Hip Screw System (DHHS), Anti-rotation screw.