الفهرس 
VASCULAR ANATOMY OF THE FEMORAL HEADOnly 14 pages are availabe for public view
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Abstract
Safe surgical dislocation of the hip is based on detailed studies of the vascular anatomy of the hip. The blood supply of femoral head is mainly based on medial circumflex femoral artery (MFCA). Obturator externus tendon is crossed posteriorly by the deep branch of MFCA which is surgically important because the tendon protects this branch from being disrupted or stretched during dislocation of hip. In its intra-articular course, it divides into posterior superior nutrient arteries of the femoral head which are the most important source of blood supply; they can completely perfuse the femoral head without any other vascular input.
The hip joint can be surgically dislocated using other approaches. However, the Ganz method of surgical hip dislocation has many advantages. Ganz surgical dislocation produces an anterior dislocation using low-grade controlled trauma. The time of dislocation is much shorter than the six-hour limit which is thought to be critical after traumatic dislocations. All external rotator muscles are left intact and, therefore, protect the MFCA. Intraoperative monitoring of perfusion of the femoral head is possible. The abductor muscles are detached by trochanter flip osteotomy and rigid fixation of the fragment restores immediate stability and allows for early mobilization of the patient.
The technique of surgical dislocation allows visualization of the femoral head of almost 360° and complete access to the acetabulum. It is a very useful procedure for the exposure of intra articular pathologies of the hip and enables complete evaluation of femoral head and neck contour. With this approach, surgeons are able to perform labral repair, resection of the acetabular rim, relative femoral neck lengthening, fracture reduction, reduction of a slipped capital femoral epiphysis, proximal femoral osteotomies and tumor resection.
Surgical hip dislocation is a safe procedure with a low complication rate. This technique provides comprehensive deformity correction, with access to both the intra-articular and extra-articular structures, and without the limitations and difficulties that are encountered during hip arthroscopy.
However, this operation is highly invasive, several weeks of partial weight bearing, blood loss, risk of trochanteric osteotomy nonunion, hardware pain and technical experience.