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Femoral Head & Neck Osteotomy - Coggle Diagram
Femoral Head & Neck Osteotomy
Approach
Craniolateral approach to the hip
Craniolateral skin incision centred over hip joint
Retract biceps femoris caudally
Retract tensor fasciae latae cranially
Incise vastus lateralis and reflect ventrally
Incise joint capsule
Start at dorsal acetabular rim
Go down to vastus lateralis isertion
Add stay sutures to lateral edges
Palpable landmarks
Wing of ilium
Greater trochanter
Tuber ischiae
Incise fascia between biceps femoris caudally and tensor fascia cranially - Will extend along cranial edge of superficial gluteal
Another incision more deeply to sepearte TFL and vastus lateralus
Gelpi Between TFL and biceps femoris
Identify superficial and middle gluteal muscles
Find cranial edge, retract, and bluntly separate this
This will expise glistening, white tendon of deep gluteal
Tenotomy
Incise half of tendon,
Bluntly separate tendon from deeper fascia
Make L shaped incision proximally - turn scissors 90 degrees
Place stay suture on this area and retract dorsally
Blunt dissect down to joint capsule
Luxate the hip
Cut
Incise round ligament
Place lateral traction on greater trochanter
Place curved scissors into joint and cut ligament
Luxate femoral head
Externally rotate limb so that stifle is parallel to table
Identifyu cut line - perpendicular to table, at junction of femoral neck and metaphysis
Cut it
Smooth out edges of ostectomy using rasp or Rongeurs
Close
Suture joint capsule over acetabulum
Close vastus lateralis
Close SubQ
Close skin
Place soft tissue between Femur and acetabulum
May need to use deep gluteal m