Quantification of Femoral Neck Exposure Through a Minimally Invasive Smith-Petersen Approach
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
Pagination or Media Count:
Objectives To quantify the area of osseous exposure and identify six anatomic landmarks using a direct anterior approach to the hip. Methods Ten fresh frozen hemipelves were dissected using a minimally invasive Smith Petersen approach. Upon completion of the exposure, a calibrated digital image was taken from the surgeon s perspective. Identification of six osseous landmarks anterior superior acetabulum, anterior inferior acetabulum, greater trochanter, lesser trochanter, anterior inferior iliac spine, and vastus ridge was attempted either by direct visualization or palpation with a tonsil clamp. These landmarks exceed the border for any intracapsular hip fracture. The digital images were then analyzed using a computer software program, ImageJ National Institutes of Health, Bethesda, MD, to calculate the square area of proximal femur exposed. Results The average square area of proximal femur exposed was 20.31 cm2 standard deviation 3.09, range 15.16 24.18. The area exposed correlated with the original height of the cadaver r 0.69, P less than 0.05. With the numbers available, there was no correlation between exposure and weight P 0.71 or body mass index P 0.87. In all 10 cadaver specimens, the 6 osseous landmarks were easily identified, 5 by direct visualization and 1 by palpation lesser trochanter, deep portion because of incomplete visualization. Conclusions The minimally invasive Smith Petersen approach to the hip allows for a wide exposure of the femoral neck averaging 20.31 cm 2 and identification of six bony landmarks of the hip.
- Anatomy and Physiology
- Medicine and Medical Research