- See: hip capsule
- femoral neck frx may increase intracapsular pressure and capsular distention;
- this may decrease perfusion through the capsular vessels and contribute to development of osteonecrosis;
- immediate joint aspiration following femoral neck frx may reverse intracapsular pressure and AVN;
- Capsulotomy Technique:
- straight lateral incision is made from the top of the trochanter to point 1 cm distal to the lesser trochanter;
- fascia lata is incised longitudinally & vastus lateralalis either split or lifted anteriorly;
- capsular attachements at trochanteric ridge/vastus tubercle can be exposed with anterior retraction and the capsule incised in line w/ neck of the femur and released proximally and distally from intertrochanteric ridge to produce a T shaped capsulotomy
Intracapsular pressure and caput circulation in nondisplaced femoral neck fractures.
Hip Joint Tamponade - an etiologic factor in the osteonecrosis of Legg Calve Perthes Disease. Gershuni PH, Hargens AR, Greenberg EN, et al. Trans Orthop Rec Soc. Las Vegas, Feb 1981.