THE TRUMBLE OPERATION FOR FUSION OF THE HIP

¹ Lakeville State Sanatorium, Middleboro, Massachusetts

Thirteen patients with tuberculosis of the hip joint have been treated at the Lakeville State Sanatorium, by the Trumble operation. Of these, seven had their operations more than one year ago and have solid bony fusion (Table I). The remainder have not been treated sufficiently long for a final end result. All of the patients are doing well, however, and the outlook for successful fusion is excellent. So far, there have been no failures and only two complications.

One complication concerned a tibial graft which slipped out of the window in the ischium, because the graft had been cut too short. This was a technical error in measurement, and the graft did not penetrate into the substance of the ischium. A graft of greater length, taken two weeks after operation from the opposite tibia, was used to replace the dislocated one. Instead of discarding the short graft, it was put into the bed of the tibia from which the longer graft had just been removed. Healing progressed favorably after the second operation.

The second complication had to do with a small pressure area over the head of the fibula, produced by the plaster leg cast, which caused a transient peroneal palsy. A window was cut in the cast to relieve this pressure, and the signs of paralysis soon began to disappear. Full recovery resulted.

Roentgenograms of the seven patients whose operations were performed a year or more ago are shown (Figs. 4 to 10, inclusive).

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