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The Journal of Bone and Joint Surgery, Vol 70, Issue 6 839-843, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Sepsis of the hip in paraplegic patients

N Klein, T Moore, D Capen and S Green
Rancho Los Amigos Medical Center, Downey, California 90242.

For the treatment of chronic sepsis of the hip in paraplegic patients, we adopted three measures: (1) a Girdlestone procedure, (2) transposition of the vastus lateralis muscle into the void that was left by the removal of the femoral head and neck and the acetabular wall, and (3) external fixation to prevent unrestrained motion of the femoral shaft, which might damage the transposed muscle. The hip joint was spanned by a posterior pelvic-femoral skeletal external fixator. Nine patients, all of whom had thoracic-level paraplegia, were treated in this manner. The fixator was kept in place for three to six weeks while the patients were cared for in the prone position. All of the infections were fully healed by twelve weeks postoperatively. In two patients, the wound drained at the edge of the flap for a short time.
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