Anteromedial Approach to Distal Two Thirds of Femur

Anteromedial approach to the distal femur through a long medial incision, with a large periarticular clamp holding the reduction
Anteromedial approach to the distal femur through a long medial incision, with a large periarticular clamp holding the reduction. Image from Fogagnolo F, Tavares RA. Current Concepts in the Treatment of Distal Femur Fractures in Adults. Rev Bras Ortop (Sao Paulo). 2026, 61(2), s00461822639. CC BY 4.0.
Anteromedial Approach to Distal Two Thirds of Femur, vastus medialis
Vastus medialis. Image by modified by Uwe Gille, Wikimedia Commons, Public domain.

Position

  • supine
  • prep & drape leg free

Landmarks

  • Vastus medialis
  • Medial joint line
  • Medial epicondyle
  • Patella

Incision

  • 15 cm longitudinal incision centred over anteromedial aspect of thigh over interval between rectus & vastus medialis
  • extend incision medial to patella

Internervous Plane

Superficial Dissection

  • Subcutaneous fat
  • Incise the deep fascia in line with skin incision
  • Identify & develop the plane between vastus medialis & rectus femoris
    • Cutting along the edge of quadriceps tendon
    • Leaving a cuff for later repair

Deep Dissection

  • Extend my incision proximally & distally exposing the anterior aspect of distal femur
  • Proximally
    • Split vastus intermedius in line with its fibres

Dangers

  • Vessels
    • Medial superior geniculate artery

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.