Femoral head ostectomy

The Femurkopfresektion is a surgical procedure in which the head of the femur ( femoral ) is surgically removed. In humans, the Femurkopfresektion is a necessary substep when inserting an artificial hip joint. Without insertion of a hip joint prosthesis, the operation is performed, however, only in very exceptional situations, such as in non-responding to treatment purulent inflammation of the hip joint. You humans leads to severe impairment of the ability to walk.

In dogs, Femurkopfresektion is performed frequently. Indications are, above all, aseptic necrosis and chronic, extremely painful hip arthrosis, as they occur, especially with hip dysplasia (HD). The Femurkopfresektion leads to the formation of a fibrous connection between the pelvis and thigh bone ( pseudarthrosis), which usually leads indeed to an impairment in the hip, but the animal has a reasonable quality of life. It is used when cost or age reasons comes a hip replacement in question.

Femurkopfresektion in dogs

The procedure is performed under general anesthesia. In most cases, an approach to the hip of craniolateral (side - front) is selected. After a skin incision above the hip joint, the fascia is cut at the anterior border of the biceps femoris muscle. The gluteus superficialis is transferred to the rear, possibly severed his tendon. The gluteus medius is shifted with retractors move upward ( dorsal), the biceps femoris to the back. The mixture of the gluteus profundus is partially severed and dissolved the vastus lateralis muscle at its origin from the femur. With a bone lever now, the head of the thigh bone from the iliac pan can be leveraged, with an intact femoral head ligament ( ligamentum capitis femoris ossis ) this is severed. The femoral neck is now osteotomy with a saw or after application of bore channels with an osteotome, in avascular necrosis of the head can also be gradually removed with a rongeur. Then the wound is closed.

Femurkopfresektion in humans

The Femurkopfresektion is a necessary step in the implantation of a total hip endoprosthesis. As the sole measure is rarely indicated in humans, as in the rare cases of chronic, treatment-resistant purulent coxitis. As a rule, endoprosthetic treatment after renovation of the infection is sought in these cases. Stubborn infections as a complication of arthroplasty force occasionally for temporary removal of the prosthesis, which then also creates the situation of a Femurkopfresektion. There then remains a so-called Girdlestone situation: the greater trochanter is supported on the iliac wing, resulting in a very restricted ability to walk on crutches results with significant shortening of the leg.