Trans-gluteal approach for hemiarthroplasty of the hip.

An approach to the hip through the anterior capsule via a lateral incision is described, which gives excellent access to the medullary canal of the upper femur and is, therefore, suitable for hip hemiarthroplasty. It utilizes the principle that gluteus medius and vastus lateralis are in anatomical continuity. The gluteus medius is split vertically and the anterior portion detached from the greater trochanter. After reattachment its position, as shown by marking clips and post-operative radiographs, remains unaltered. A new retractor, specially designed for use with this approach, is described. A series of 40 hemiarthroplasties using this technique is presented.