ORIF of right hip Pinning and fluoroscopy of right hip.

PREOPERATIVE DIAGNOSIS:  Right hip subcapital impacted fracture.

POSTOPERATIVE DIAGNOSIS:  Right hip subcapital impacted fracture.

OPERATIONS PERFORMED:

1.  ORIF of right hip.

2.  Pinning and fluoroscopy of right hip.

BLOOD LOSS:  Minimal.

FLUIDS:  Crystalloids.

COMPLICATIONS:  None.

HARDWARE USED:  Three cannulated screws from Richards.

HISTORY:  The patient is a woman with a right hip impacted femoral neck fracture.  Risks, benefits, and alternatives of treatment discussed.  She wished to proceed with surgery.

PROCEDURE IN DETAIL:  The patient was identified, brought to the operating room, and placed in supine position on the table.  After induction of spinal anesthetic, the patient was positioned on a fracture table.  The fracture of the right hip was appropriately reduced and positioned.  The right hip was then sterilely prepped and draped in the usual fashion for the surgery.  The fracture was an impacted femoral neck fracture.  This was felt to be amenable to treating with screw fixation.  At this time, the bur was brought in and small incision was made on the lateral side of the right hip.  Dissection was carried down to the femur through the IT band and the vastus lateralis was elevated off the bone.  We then placed a guidepin up into the center of the femoral head.  We then used the _____ to place two additional pins trying to stay within the posterior and inferior aspects of the femoral head for the best purchase.  Three consecutive screws were then placed under fluoroscopic control into the femoral head with excellent fixation.  Once this was done and the fixation was solid, the wounds were irrigated.  We then closed in layers using 0 Vicryl, 2-0 Vicryl, and staples for the skin.  Sterile dressing was applied.  My assistant was essential during this case.