The direct lateral approach to the hip

A direct lateral approach to the hip is described which allows adequate access for orientation of the implant, for the insertion ofthe cement and for the correction ofdiscrepancy in leg length. An anatomical observation was made that the gluteus medius muscle is inserted into the greater trochanter by a tendon and that the axis of the shaft of the femur lies anterior to the main bulk of the muscle which was left r N’ I The patient is placed in the supine position with the greater trochanter lying at the edge of the table, thus freeing the muscles of the buttock from the table. The skin incision has the greater trochanter as its midpoint longitudinally and extends eight centimetres parallel to the shaft of the femur along its anterior border. Proximally the incision extends in a posterior direction and ends at the level of the anterosuperior iliac spine, although in patients with much muscle the