Modification of the anterior iliofemoral approach to the hip

This paper describes a modified iliofemoral surgical approach to the hip joint performed on 282 patients over a 26-year period. The surgical technique follows the anterior iliofemoral approach except that the lateral "bone overhang" of the iliac crest is osteotomized and dissected distally with the fascia lata to expose the hip capsule. The "six muscle glove" is sharply dissected off the greater trochanter, the hip capsule is opened and surgery is carried out, upon completion of which the operated leg is abducted. The osteotomized iliac crest bone-graft with the attached muscles is reapproximated to its anatomical position and fixed with permanent sutures through five holes drilled through the replaced bone graft and the intact ilium. The closure is rapidly performed, strong, and allows early functional return. Blood loss is relatively slight.