A lateral intermuscular approach to the hip joint for replacement of the femoral head by a prosthesis.

The purpose of this communication is to present a simple method of exposure of the hip joint for the insertion of an artificial femoral head in patients who have fracture of the femoral neck or osteoarthritis of the hip, many of whom are old or feeble. For fractures of the femoral neck, the prevalent view seems to be that operation should always be undertaken unless the patient is moribund or suffering from advanced senile mental change (Williams and McLean 1952). Hitherto it has been thought that a rapid extra-articular nailing operation disturbs the patient least. Replacement of the femoral head by a prosthesis, through the exposure described here, is considered to be no more dangerous than an extra-articular nailing operation. In the treatment of osteoarthritis of the hip, many patients are over seventy years of age and the natural tendency is to avoid the risk of surgery. Replacement of the femoral head by way of this lateral intermuscular approach proves not to be a severe ordeal. Essentially, the surgical approach advocated here is a modification of that described by Watson-Jones (1936), in which neither muscle nor tendon is divided.