Exposure of the hip by anterior osteotomy of the greater trochanter.

A new exposure for the direct lateral approach to the hip through the gluteus medius by anterior half osteotomy of the greater trochanter is described. The skin incision is made with the greater trochanter longitudinally at its midpoint and extends parallel to the shaft of the femur along its anterior border. The anterior two thirds of the tendinous gluteus medius muscle is divided. The incision continues to the middle of the greater trochanter and through the distal half of the vastus lateralis muscle. An anterior thin slice osteotomy of the greater trochanter is performed. The gluteus minimus is exposed and split in the line of its fibers or detached from the greater trochanter and the acetabular roof is exposed. In order to provide a wide exposure, a Charnley transverse retractor is used and a Calipers Dual Pin Retractor is inserted over the edge of acetabulum by elevating the soft tissues from the ilium. The Calipers Dual Pin Retractor is used to precisely position the prosthesis in an anatomic and functional position and eliminate leg length discrepancy.