9
Step 4 – Determining the Incision
Point and Implant Position
Slipping of the femoral head occurs
in a true posterior direction.
The Hansson Pin must be positioned
in the central part of the femoral head.
To achieve this, the pin must be
inserted anterior-laterally in the
greater trochanter and then directed
posteriorly (Fig. 6).
A prerequisite for being able to
correctly position the Hansson Pin
is to insert a Ø2.4mm Guide Wire
prior to drilling.
Guide Wire Insertion Point –
Anterior / Posterior View:
Position a Guide Wire on the skin
of the anterior aspect of the thigh.
Verify by anterior/posterior
fluoroscopy that the Guide Wire
is in the correct position in the central
part of the femoral neck and head
(Fig. 7). Mark the position of the
Guide Wire on the anterior surface
of the thigh.
Lateral / Medial View:
Now position the Guide Wire over the
skin on the lateral aspect of the thigh.
Verify by lateral/medial fluoroscopy that
the Guide Wire has been positioned to
enter posteriorly towards the central
part of the femoral head (Fig. 8)
Mark the position of the Guide Wire
on the lateral aspect of the thigh.
The intersection of these two lines at
the anterior-lateral aspect of the thigh
at the level of the lesser trochanter
represents the optimal point for
percutaneous insertion of the Guide
Wire (Fig. 9).
Fig. 6 – Final Implant Position to Achieve
Fig. 8 – L/M X-Ray of Guide Wire over skin
Fig. 7 – A/P X-Ray of Guide Wire over skin
Fig. 9 – Incision and Guide Wire Insertion Point
Operative Technique
