Klein N, Moore T, Capen D, Green S
Rancho Los Amigos Medical Center, Downey, California 90242.
J Bone Joint Surg Am. 1988 Jul;70(6):839-43.
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.
对于截瘫患者髋部慢性脓毒症的治疗，我们采取了三种措施：（1）Girdlestone手术；（2）将股外侧肌转位至因切除股骨头、颈及髋臼壁而留下的空隙处；（3）进行外固定以防止股骨干不受控制地活动，因为这可能会损伤转位的肌肉。髋关节由后路骨盆 - 股骨骨外固定器固定。9例患者均为胸段截瘫，均采用此方法治疗。固定器保留三至六周，期间患者俯卧位护理。所有感染在术后十二周时均完全愈合。有2例患者，皮瓣边缘的伤口短期内有引流液。
