Archives of Orthopaedic and Trauma Surgery

, Volume 111, Issue 4, pp 220–223 | Cite as

The transgluteal approaches to the hip

  • B. Heimkes
  • P. Posel
  • M. Bolkart
Original Articles


The transgluteal approach to the hip, first described by Bauer et al. [1] in 1979, has since become a recognized routine method. Its longitudinal incision of the fibers of the gluteus medius and minimus and the vastus lateralis muscles takes advantage of the tendinous junction of these muscles over the greater trochanter. This paper describes the modifications of the transgluteal approach described in the literature and compares them to the original procedure. In 52 hip specimens, including attached muscles, the insertions and different variations of the junction of the gluteus medius, minimus and vastus lateralis muscles over the greater trochanter are described and statistically analysed. In 59.6% of all specimens there proved to be a united tendinous junction of all the muscles referred to above, while in 40.4% autonomous insertions of the gluteus medius and/or gluteus minimus were seen. In accordance with the anatomical results, the form of incision described by the original authors can be considered the most favourable. In roughly one-third of all hip operations, autonomous insertions of gluteus medius and minimus must be taken into account, since otherwise total or partial upward displacement of the autonomous muscle insertions could occur.


Public Health Vastus Lateralis Great Trochanter Routine Method Longitudinal Incision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bauer R, Kerschbaumer F, Poisel S, Oberthaler W (1979) The transgluteal approach to the hip joint. Arch Orthop Trauma Surg 95:47–49Google Scholar
  2. 2.
    Bell SN (1985) Transgluteal approach for hemiarthroplasty of the hip. Arch Orthop Trauma Surg 104:109–112Google Scholar
  3. 3.
    Dall D (1986) Exposure of the hip by anterior osteotomy of the greater trochanter. J Bone Joint Surg [Br] 68:382–386Google Scholar
  4. 4.
    Gibson A (1950) Posterior exposure to the hip joint. J Bone Joint Surg [Br] 32:183–186Google Scholar
  5. 5.
    Hardinge K (1982) The direct lateral approach to the hip. J Bone Joint Surg [Br] 64:17–19Google Scholar
  6. 6.
    Harris W (1949) A new lateral approach to the hip joint. J Bone Joint Surg [Am] 49:891Google Scholar
  7. 7.
    McFarland B, Osborne G (1954) Approach to the hip. A suggested improvement on Kocher's method. J Bone Joint Surg [Br] 36:364–367Google Scholar
  8. 8.
    McLauchlan J (1984) The Stracathro approach to the hip. J Bone Joint Surg [Br] 66:30–31Google Scholar
  9. 9.
    McMinn RMH, Hutchings RT, (1977) Colour atlas of human anatomy. Scribner, New YorkGoogle Scholar
  10. 10.
    Nazarian S, Tisserand Ph, Brunet Ch, Müller ME (1987) Anatomic basic of the transgluteal approach to the hip. Surg Radiol Anat 9:27–35Google Scholar
  11. 11.
    Picard JJ, Trinh Van Dam (1983) Voie d'accès antéro-externe de la hanche. Traitement du descellement des prothèses totales de hanche. Cinquièmes Journeés de Chirurgie de la Hanche. Lyon, 2–3 December 1983Google Scholar
  12. 12.
    Schiebler TH (ed) (1977) Lehrbuch der gesamten Anatomie des Menschen. Springer, Berlin Heidelberg New YorkGoogle Scholar
  13. 13.
    Warwick R, Willians PL (1980) Gray's anatomy, 36th edn. Longman, LondonGoogle Scholar
  14. 14.
    Watson-Jones R (1936) Fractures of the neck of the hip. J Bone Joint Surg [Br] 23:787–808Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • B. Heimkes
    • 1
  • P. Posel
    • 2
  • M. Bolkart
    • 1
  1. 1.Orthopädische Poliklinik Innenstadt der Ludwig-Maximilians-Universität MünchenMunich 2Germany
  2. 2.Anatomische Anstalt der Ludwig-Maximilians-Universität MünchenMunich 2Germany

Personalised recommendations