A complicated trochanteric pressure sore: what is the best surgical management? Case report

Paraplegia
J Benito-RuizJ Montanana-Vizcaino

Abstract

Pressure sores are a common complication after spinal cord injury. But great advances in their management (nursing care, prevention and surgery) have been made in the last four decades. Neglected pressure ulcers may affect the adjacent joint, leading to septic arthritis. We report a paraplegic patient with a large trochanteric sore with hip arthritis, in whom we performed an upper femoral resection and acetabular curettage (Girdlestone's technique) and coverage with the homolateral vastus lateralis muscle flap in one stage. Some questions pertaining to this operation are discussed and there is a comparison with other ways of management described in the literature. We conclude that a successful outcome with the management of such large sores depends on a radical, aggressive operation to remove all of the affected tissue, and ensure a safe coverage with a reliable, viable muscle flap. The collaboration and the positive attitude of the patient towards the procedure and the result obtained are decisive in preventing recurrences.

References

Sep 1, 1988·Annals of Plastic Surgery·N E KleinD Capen
Sep 1, 1987·Archives of Surgery·R L Lawton, V De Pinto
Aug 1, 1969·Plastic and Reconstructive Surgery·J RoyerF Thorne
Mar 1, 1956·Plastic and Reconstructive Surgery·N GEORGIADEC MAGUIRE

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