Safe surgerical dislocation of hip

1. Safe Surgical Dislocation of Hip Joint
Dr. Ashwani Jangir
Assistant Professor ,
Orthopaedics ,
SP Medical College , Bikaner

2. Safe Surgerical Dislocation -
● Approach to the hip joint .
● Based on detailed study of the blood supply to the hip
joint .
● Involve dislocation of hip joint without compromise of
femur head vascularity .

3. Original Article -

4. Vascular Anatomy
● 90 % from Medial Circumflex femoral artery [MCFA] ,
main blood supply to weight bearing portion of femoral
head .
● 10% from LCFA & artery to ligamentum teres

6. Indication -
● FAI
● SCFE
● Femur head #
● Acetabular # - superior wall extension
● Femoral head reshaping osteotomy

7. Surgical Approach
● Originally through KOCHER LANGENBECK approach.
● Modification - GIBBSON APPROACH
● In Gibbson approach proximal incision directed anterior to
KL approach .
● Dissection between TFL & Gluteus maximus .
● Entire gluteus maximus retracted posteriorly .

8. Patient positioning -

9. INCISION -

11. Superficial surgical dissection -

12. Deep dissection -

14. Trochanteric osteotomy -

19. Capsulotomy -

20. Dislocation of hip joint -

21. Capsule closure -

22. Reduction & Fixation of trochanteric flip -

23. Closure of fascia -

24. Complications -
● Avascular necrosis - 1 to 5 % in non traumatic case
● Sciatic nerve palsy - < 1%
● Delayed / Non union of trochanteric osteotomy
● Heterotopic ossification - 10 to 20 % , less compare to
anterior approach
● Infection - < 1%

25. THANK
YOU !