Hip – Medial

PositionSupine, hip flexed, abducted and externally rotated
Skin3-4 cm incision parallel and 1cm distal to the groin crease
SuperficialAdductor longus is divided close to the pubic tubercle Obturator nerve (anterior branch) is identified and protected
DeepBetween pectineus and adductor brevis Medial Femoral Circumflex Artery is identified and protected Psoas tendon divided at insertion T shaped capsulotomy
DangersObturator nerve – predominantly anterior Femoral neurovascular bundle Medial Femoral Circumflex Artery
AdditionalDivide Transverse acetabular ligament Capsular plication Ligamentum teres tenodesis