Indications
- can expose whole femur
- especially good for distal femoral fractures
Position
- supine
- traction table
- II
- IR leg
Landmarks
- Lateral femoral condyle
Incision
- Straight longitudinal incison on posterolateral aspect of thigh centred over lateral femoral epicondyle
- Start:Lateral femoral epicondyle
A Lateral approach B Posterolateral approach
Internervous Plane
- Vastus lateralis
- Lateral intermuscular septum
Superficial Dissection
- Subcutaneous fat
- Deep fascia of thigh in line with its fibres & skin incision
- Identify vastus lateralis under fascia lata
- Follow the muscle posteriorly to lateral intermuscular septum
- Reflect the muscle anteriorly
- Dissecting between muscle & septum
- Numerus branches of perforating arteries are encountered & coagulated
- Continue the dissection onto the lateral aspect of femur
- Strip lateralis subperiosteally off the femur
Dangers
- Perforating arteries
- Superior lateral geniculate artery & vein