Evans G R, Lewis V L, Manson P N, Loomis M, Vander Kolk C A
Division of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institution, Baltimore, Md.
Plast Reconstr Surg. 1993 Feb;91(2):288-94. doi: 10.1097/00006534-199302000-00012.
Fifteen patients who underwent Girdlestone arthroplasty (proximal femoral head resection) were reviewed at The Johns Hopkins Hospital and Northwestern Memorial Hospital. Ages ranged from 24 to 57 years (mean 36.7 years). All patients were paraplegics or quadriplegics (C7-L3). All patients presented with signs of sepsis and had evidence of osteomyelitis. Soft-tissue reconstruction was most commonly performed with the vastus lateralis, and no femoral stabilization was used. There were no deaths. Recurrent ulcers at the site of the Girdlestone arthoplasty were found in 23 percent of patients in whom follow-up was possible. No recurrence was noted at the original site in 77 percent with a mean follow-up of 20 months. Additional pressure sores occurred at other nonsurgical sites in six patients at a mean of 23.3 months. Girdlestone arthroplasty with soft-tissue coverage is mandatory for successful treatment of pressure sores with hip joint involvement.
约翰·霍普金斯医院和西北纪念医院对15例行Girdlestone关节成形术（近端股骨头切除术）的患者进行了回顾性研究。患者年龄在24至57岁之间（平均36.7岁）。所有患者均为截瘫或四肢瘫（C7-L3）。所有患者均有败血症体征且有骨髓炎证据。软组织重建最常采用股外侧肌，未使用股骨稳定术。无死亡病例。在可行随访的患者中，23%在Girdlestone关节成形术部位出现复发性溃疡。平均随访20个月，77%的患者原部位未出现复发。6例患者在其他非手术部位平均23.3个月出现了额外的压疮。对于累及髋关节的压疮，采用软组织覆盖的Girdlestone关节成形术是成功治疗的必要手段。
