Figure 4.

The femoral head is dislocated anteriorly (a) by using a skid in the hip joint, anterior traction on the corkscrew handle, and gentle external rotation of the leg. Removing a few millimeters of the anterior acetabular wall will facilitate this step. With the head anteriorly dislocated, the lesser trochanter and calcar are exposed by subperiosteal elevation of the medial hip capsule (b). The proposed calcar cut has been marked with a pen, in relationship to the lesser trochanter. The corkscrew has been removed to make the calcar cut. The femoral head is removed (c) by cutting the calcar first and then making the lateral cut, thereby avoiding inadvertent injury to the greater trochanter. Another option is to remove a segment of the femoral neck in situ, followed by extraction of the head