Piriformis fossa approach in optimising femoral neck osteotomy and component positioning in hemiarthroplasty surgery for intracapsular fractured neck of femur

Figure 3 The femoral rasp inserted to a sufficient depth in the canal via the piriformis fossa. The rasp acts as a guide while diathermy is used to demarcate the angle of neck osteotomy. lies medial to the greater trochanter of the proximal femur (Fig 2). This ensures only a blunt instrument is used to create an initial passage for the femoral rasp, minimising the risk of femoral perforation. With the neck still intact, a box chisel is used to create the necessary opening for rasp insertion. The rasp is sufficiently inserted to act as a visual guide for the neck cut. Monopolar diathermy outlines the neck osteotomy (Fig 3) and, following osteotomy and head removal, the rasp is inserted to the required depth.