Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application.

Reinhold Ganz, Thomas Huff, Michael Leunig

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Osteotomies of the proximal femur for hip joint conditions are normally done at the intertrochanteric or subtrochanteric level. Intra-articular osteotomies would be more direct and therefore allow a more powerful correction with no or very little undesired side correction. However, concerns about the risk of vascular damage and osteonecrosis of the femoral head have so far basically excluded this technique from practical use. Based on detailed knowledge of the vascular anatomy of the proximal femur, an approach to safely dislocate the femoral head has been described and successfully performed. Experience as well as further studies of femoral head perfusion allowed a substantial extension of this approach, with subperiosteal exposure of the circumference of the femoral neck with constant intraoperative control of the blood supply to the head. Using the extended retinacular soft-tissue flap, four surgical techniques (relative neck lengthening, subcapital realignment in slipped capital femoral epiphysis, true femoral neck osteotomy, and femoral head reduction osteotomy) evolved or became safer with respect to perfusion of the femoral head. The extended retinacular soft-tissue flap offers the technical and biologic possibility for a new class of intra articular procedures. Although meticulous execution of the surgical steps is important, the procedures have a high level of safety for femoral head perfusion.

Original languageEnglish (US)
Pages (from-to)241-255
Number of pages15
JournalInstructional course lectures
Volume58
StatePublished - 2009
Externally publishedYes

Fingerprint

Thigh
Hip
Joints
Osteotomy
Perfusion
Femur Neck
Femur
Blood Vessels
Slipped Capital Femoral Epiphyses
Surgical Flaps
Osteonecrosis
Hip Joint
Anatomy
Neck
Head
Safety

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Extended retinacular soft-tissue flap for intra-articular hip surgery : surgical technique, indications, and results of application. / Ganz, Reinhold; Huff, Thomas; Leunig, Michael.

In: Instructional course lectures, Vol. 58, 2009, p. 241-255.

Research output: Contribution to journalArticle

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