1. Ljubomir Panajotović, Albania
Trochanteric pressure ulcers differ from sacral and ischial ulcers in their propensity to develop sinus tracts, penetrate bursa, enter joint cavities through destruction of the joint capsules and cause septic arthritis or joint destruction and dislocation.
We present seventeen posttraumatic paraplegic patients with septic arthritis of trochanteric joint we treated. Five patients had bilateral localization of pyarthrosis. All of them had systemic signs of sepsis.
Each patient underwent Girdlestone resection of proximal part of the femur. We obliterated dead space with vastus lateralis muscle flap and defect closure was made with tensor fasciae latae transposition flap. The current irrigation drainage system was applied under the flaps. We started with systemic administration of antibiotics prior to surgery and continued with them following surgery.
Most flap wounds healed within an average of 6 weeks. In two cases with pyoarthros of trochanteric and knee joint we made above-knee amputation , filleted and used the entire thigh for flap coverage. In one patient the great problem was femoral pistoning. It was needed repeated operations, antispasmodic medication and strict immobility of the leg after operation. Regardless of surgery and antibiotics one patient with quadriplegia and multiple pressure sores died in sepsis.
Ključne reči :
Tematska oblast:
FMR u ortopediji i traumatologiji
Uvodni rad:
Da
Datum:
20.07.2012.
Br. otvaranja:
453
