Ludloff access

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The Ludloff access is named after the physician Karl Ludloff .

It is a medial surgical access route on the inside of the thigh with open hip reduction , which Ludloff first described in 1908. This was modified by Salzer and Zuckriegl in 1967 and is still used today in the treatment of dislocation of the hip joint .

Course of operation

The patient is operated on in the supine position, with the operation being performed with the leg flexed (90 ° bent) and abducted in the hip joint (in Lorenz's primary position). The skin penetration begins at the inguinal ligament at the edge of the adductor longus muscle , which is clearly defined by the primary position, against the femoral artery and is approximately 5 to 8 cm long. The fasciae are divided lengthways, the adductors are displaced, and the surgeon enters the anterior edge of the adductors. In the depths one then goes bluntly between the visible M. pectineus and the M. iliopsoas . Larger vessels are left lateral . The joint capsule becomes visible under the pectineus muscle. At this point, the branches of the arteria and the circumflexa femoralis tibialis vein , which run over the pectineus muscle, must be spared. The joint capsule can then be opened up to the femoral head . A reduction attempt can be made.

literature

  • Dietrich Tönnis: Congenital hip dysplasia and hip displasia in children and adults: Basics, diagnostics, conservative and surgical treatment , Springer-Verlag, p. 252 ff., 2013

reference

  1. ^ Reingard M. Aigner: Orthopedics and orthopedic surgery: the standard work for clinics and practices. Pelvis, hip: 114 tables . Georg Thieme Verlag, 2004, ISBN 978-3-13-126221-9 ( google.de [accessed December 8, 2017]).
  2. ↑ Werner Konermann, Gerd Gruber, Christian Tschauner: The hip maturation disorder: diagnosis and therapy . Springer-Verlag, 2013, ISBN 978-3-642-58695-8 ( google.de [accessed December 8, 2017]).
  3. ↑ Max Lange: Orthopedic-surgical operation theory: Supplementary volume: Latest surgical procedures . Springer-Verlag, 2013, ISBN 978-3-642-87749-0 ( google.de [accessed December 8, 2017]).