The Modified Girdlestone Procedure With Muscle Flap for Management of Pressure Ulcers and Heterotopic Ossification of the Hip Region in Spinal Injury Patients: A 15-Year Review With Long-term Follow-up

Annals of Plastic Surgery
S RubayiKevin Ruhge

Abstract

Pressure ulceration, pyogenic arthritis, and hip heterotopic ossification are complications encountered in spinal cord injury patients. The Girdlestone procedure has been established as an effective treatment modality for hip pathology in this population and is particularly efficacious when a muscle flap is used to fill the femoral resection defect. We previously reported its use as a 3-stage procedure. Through time, experience was gained, and consequently, our technique has evolved to a 1-stage procedure. A retrospective analysis of all spinal cord injury patients who had undergone Girdlestone arthroplasty or excision of heterotopic ossification by the pressure ulcer management team at Rancho Los Amigos National Rehabilitation Center between 1991 and 2005 was performed. A description of our management, operative protocol, outcome, and complication is given. Over 15 years (between 1991 and 2005), 295 patients underwent 330 procedures. Hips were operated for infection, heterotopic ossification, pressure ulceration, dislocation, femoral head necrosis, or fracture or a combination of the above. Twenty-five cases (7.6%) required surgical revision for wound breakdown in the immediate postoperative period. Average follow-up was 40.3 ...Continue Reading

References

Mar 1, 1992·The Journal of Bone and Joint Surgery. British Volume·R H WittenbergU Bötel
Jan 1, 1989·Archives of Orthopaedic and Trauma Surgery·R T MüllerH Konermann
Sep 1, 1988·Annals of Plastic Surgery·N E KleinD Capen
Apr 1, 1987·Plastic and Reconstructive Surgery·M A Drimmer, M J Krasna
Oct 1, 1983·The Journal of the American Paraplegia Society·I Eltorai
Feb 1, 1993·Plastic and Reconstructive Surgery·G R EvansC A Vander Kolk
Jan 16, 2008·Clinical Orthopaedics and Related Research·G R Girdlestone

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Citations

Nov 7, 2018·Journal of Wound Care·Malte OhlmeierMustafa Citak
Oct 16, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Arun AnejaStephen L Kates
Dec 19, 2020·Burns and Trauma·Xiangong JiaoYixin Zhang
Feb 25, 2021·Archives of Orthopaedic and Trauma Surgery·Alireza K NazemiAlexandra I Stavrakis

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