Safe Surgical Dislocation - Dr. Ashok Gavaskar

Description

This surgical technique video showcases the safe surgical dislocation approach used for treating femoral head fractures, employed by Dr. Ashok Gavaskar. It follows a detailed step-by-step procedure starting with a case of a 22-year-old male patient who suffered a femoral head fracture following a motor vehicle accident. Key moments include the initial assessment, the reduction of an associated pelvic ring injury, and intraoperative findings of a comminuted fracture, categorized as a type II Pipkin injury based on CT imaging.



The video outlines the positioning of the patient and the preparation of the surgical field, incorporating direct visualization with an image intensifier. Detailed explanations of the incision technique highlight anatomical considerations and the importance of identifying critical structures to ensure safe dissection. The video covers the sequential steps of surgery—from making a 20 cm incision, delineating the Gibson interval, extending to intratrochanteric exposure, and handling the gluteus medius and minimus muscles, to performing a trochanteric osteotomy.



Subsequent sections describe meticulous dissection techniques, capsulotomy creation, exposure of the femoral head, fracture reduction strategies, and fixation methods using 2.4 mm screws. Throughout the video, critical tips regarding surgical anatomy and avoiding complications are emphasized.



Post-operatively, considerations for patient management, including rehabilitation and follow-up protocols, are discussed, noting the expected outcomes, such as complete healing of the fracture and restoration of hip joint congruence, verified through follow-up X-rays.

Specialties