Eltorai I
J Am Paraplegia Soc. 1983 Oct;6(4):85-6. doi: 10.1080/01952307.1983.11735991.
The Girdlestone procedure which originally was developed for the treatment of tuberculosis of the hip has found a place in the management of septic hip arthritis and osteomyelitis secondary to pressure sores in spinal cord injury and other myelopathies. Eradication of the septic focus is necessary if amyloid disease is to be prevented. Early diagnosis and aggressive surgery are essential. Surgical treatment entails not only bone removal, but also a thorough joint debridement. This procedure goes hand-in-hand with the appropriate antibiotic treatment given intravenously for an adequate time (4-6 weeks). When available, hyperbaric oxygen therapy is a good treatment. It is important to obliterate a large pseudoarthrosis cavity by muscle transfer from the thigh using a hamstring or a vastus lateralis. Irrigation, suction and drainage are important until the would heals. In summary, 39 patients had 42 Girdlestone procedures without any operative mortality. Seventy percent of the wounds had healed and 30% failed to heal requiring another operation. Recurrences were observed in 10% of the patients, and these cases needed another operation together with hyperbaric oxygen therapy. Eight patients died due to other causes unrelated to the operation. The procedure is rather simple but needs prolonged postoperative care, especially with wound failure or recurrences.
最初为治疗髋关节结核而开发的Girdlestone手术，在脊髓损伤和其他脊髓病继发的化脓性髋关节炎和褥疮性骨髓炎的治疗中占有一席之地。若要预防淀粉样变性疾病，根除感染病灶是必要的。早期诊断和积极手术至关重要。手术治疗不仅需要去除骨头，还需要彻底清创关节。此手术需与静脉给予足够时间（4 - 6周）的适当抗生素治疗相结合。如有条件，高压氧治疗是一种很好的治疗方法。通过使用腘绳肌或股外侧肌从大腿进行肌肉转移来消除大的假关节腔很重要。在伤口愈合之前，冲洗、吸引和引流都很重要。总之，39例患者接受了42次Girdlestone手术，无手术死亡病例。70%的伤口愈合，30%未愈合，需要再次手术。10%的患者出现复发，这些病例需要再次手术并结合高压氧治疗。8例患者因与手术无关的其他原因死亡。该手术相当简单，但术后需要长期护理，尤其是伤口愈合不良或复发的情况。
