Surgical Discussion

Patient positioning:  Supine on traction table

Anatomical surgical approach:  Direct lateral transvastus approach (mini open anterior arthrotomy)

Under minimal axial load on the traction table, a slight correction of the posterior head tilt was successfully accomplished prior to proceeding with in situ screw fixation. A mini anterior arthrotomy was performed to alleviate intracapsular pressure. The initial fixation involved the placement of the most caudal calcar screw, which yielded excellent fracture compression in high-quality bone. Postoperative radiographs revealed optimal screw placement and final head positioning, with a reduction of posterior tilt to approximately 15 degrees and preserved valgus impaction.