Rubayi S, Pompan D, Garland D
Department of Surgery, University of Southern California, Los Angeles.
Ann Plast Surg. 1991 Aug;27(2):132-8. doi: 10.1097/00000637-199108000-00007.
A radical proximal femoral resection and flap procedure were used to treat infected trochanteric ulcers communicating with the hip joint in patients with spinal cord injuries. Postoperatively, femoral motion and pistoning were prevented by an abduction pillow and antispasmodic medication. The results of 25 patients and 26 hips with an average follow-up of 14.5 months are presented. Wound closure was achieved in 24 of 26 hips while patients were in the hospital. All wounds eventually healed, and all infections were eradicated. Seven patients had associated clinically significant heterotopic ossification. All of these patients had elimination of infection and postoperative restoration of wheelchair sitting. It is concluded that this radical procedure is extremely effective in treating deep, recalcitrant trochanteric ulcers around the hip. The procedure may potentially be used to treat heterotopic ossification about the hip and restore sitting capability in patients with spinal cord injuries.
采用股骨近端根治性切除术和皮瓣手术治疗脊髓损伤患者合并髋关节相通的感染性转子溃疡。术后，通过外展枕和抗痉挛药物防止股骨活动和活塞样运动。本文报告了25例患者26个髋关节的治疗结果，平均随访14.5个月。26个髋关节中有24个在患者住院期间实现了伤口闭合。所有伤口最终均愈合，所有感染均被根除。7例患者伴有临床上有意义的异位骨化。所有这些患者感染均消除，术后恢复了轮椅坐姿。结论是，这种根治性手术在治疗髋关节周围深部、顽固性转子溃疡方面极为有效。该手术可能可用于治疗髋关节周围的异位骨化，并恢复脊髓损伤患者的坐姿能力。
