Lateral Approach to the Femur

Essence

  • Vastus Lateralis

Position

  • supine on traction table
  • IR leg so that patella is pointing upwards
  • Check with II

Landmarks

  • Greater trochanter
  • Shaft of femur
  • knee

Incision

  • Straight longitudinal incision centred over the lateral aspect of thigh
  • Start: greater trochanter

Superficial Dissection

  • Subcutaneous fat
  • Incise the fascia lata of thigh in line with skin incision
  • Upper end of wound
    • Tensor fascia latae may need to be split in line with its fibres

Deep Dissection

  • Vastus lateralis split
    • Place 2 sharp homan retractors through vastus lateralis on either side of femur
    • Pull retractors apart to split vastus lateralis
    • Continue dissection through lateralis
    • Several vessels cross the field & will need to be coagulated
  • Exposes lateral surface of femur
  • Vessels
    • Perforating branches of profunda femoris artery