Left Hip Hemiarthroplasty for Femoral Neck Fracture

1. Introduction

2. Slightly Curvilinear Incision Centered Over the Greater Trochanter

3. Dissection Through the Soft Tissues and Exposure of the IT Band

4. Longitudinal Incision Through the IT Band and Retraction to Expose the Greater Trochanter

5. Anterolateral Approach to Expose the Hip Capsule by Peeling Off the Confluent Layer of Abductors and Vastus Lateralis at its Insertion onto the Greater Trochanter

6. T-Shaped Capsulotomy and Exposure of the Femoral Neck Fracture

1. Tag the Two Corners of the Capsulotomy Leaflets

7. Femoral Head Removal and Washing Away any Bone Fragments

8. Femoral Head Measurements and Trialing Femoral Head Implant

9. Getting Lateral on the Canal with a Box Cutter While Protecting the Insertion of the Abductors

10. Using Canal Finder and Reamers to Appropriately Size the Canal

11. Femoral Broaching to Appropriately Size the Canal

12. Trial for New Femoral Neck and Head

1. Reduction of Trial Components and Confirmation of Appropriate Sizing
2. Verify with Flat Plate X-Ray

13. Cement Mixing and Femoral Canal Irrigation and Hemostasis

14. Cement Placement with Cement Restrictor at the Bottom

15. Femoral Stem Insertion Making Sure of Appropriate Version and Valgus Position

16. Attachment of New Femoral Head and Reduction of the Hip

17. Closure

1. Capsule by Tying Together the Two Tagging Sutures
2. Abductors and Vastus Lateralis to the Greater Trochanter with Horizontal Mattress Sutures with #5 Ethibond
3. Final Confirmation with Flat Plate X-Ray
4. IT Band with #1 Vicryl
5. Skin and Soft Tissues

18. Post-op Remarks