- Discussion:
- insert blunt Homan retractors superiorly & inferiorly to obtain exposure of
entire superior, posterior, & inferior portions of capsule;
- divide exposed portion of capsule along its attachment to femur;
- make a longitudinal or T shaped extension of capsular incision
along axis of femoral neck, directing incision away from
sciatic nerve;
- retract the capsule, preserving for later repair;
- excise the acetabular labrum;
- isolate anterior capsule by passing a curved clamp w/in sheath
of
psoas tendon;
- retract femur ant. w/ bone hook to place capsule under tension;
- carefully divide anterior capsule between the jaws of the clamp;
- place curved cobra or Hohmann retractor in interval between the
anterior lip of acetabulum &
psoas tendon;
- errant placement of this retractor over the
psoas tendon may
cause injury to femoral nerve or adjacent vessels;
- if after complete capsulotomy, femur cannot be fully retracted
anteriorly, then divide tendinous insertion of
maximus
leaving a 1 cm cuff of tendon on femur for subsequent reattachment;
