Anterior Hip (Smith-Peterson)

Question 1

Internervous plane

Answer 1

Superficial
Sartorius (fem n) + TFL (sup glut n)

Deep
      rectus femoris (fem n) + glut med (sup glut n)

Question 2

Incision

Answer 2

from anterior 1/2 of iliac crest to ASIS curving inferiorly towards lateral patella

Question 3

superficial dissection

Answer 3

through subcut fat between sartorius + TFL - BEWARE lateral femoral cutaneous nerve

incise fascia on medial side of TFL

Detach TFL to develop the plane

ligate ascending branch of lat fem circumflex a

Question 4

Deep dissection

Answer 4

identify plane between rectus femoris + gluteus medius

detach rectus from both its origins

retract rectus + iliopsoas medially + glut medius laterally to expose the hip capsule

adduct + externally rotate the hip to place the capsule on stretch

incise capsule with a longitudinal or T-shaped capsular incision

dislocate hip with external rotation after capsulotomy is complete

Question 5

Dangers

Answer 5

Lateral femoral cutaneous nerve

femoral nerve - stay lateral to sartorius

ascending branch of lateral femoral circumflex artery - in plane between sartorius + TFL)