Hip disarticulation for severe lower extremity infections.
Hip disarticulation is rarely performed for infections and variable mortality rates have been reported. We determined the number of deaths following hip disarticulation for severe lower extremity infections in 15 patients. Indications for hip disarticulation were necrotizing soft tissue infections in seven patients and persistent infections of the proximal thigh in eight patients. The most common microorganism was Staphylococcus aureus, present in eight patients. Hip disarticulation was performed emergently in seven patients and electively in eight patients. All patients survived the operation and at 1 month postoperatively 14 of 15 patients were alive. Hip disarticulation for these severe infections had high survival, even when performed emergently for life-threatening infections. We believe hip disarticulation is a reasonable option treating severe infections of the lower extremity and should be part of the armamentarium of the orthopaedic surgeon.


METHODS
Level IV, therapeutic case series.
Zalavras
Charalampos G
CG
Department of Orthopaedic Surgery, LAC+USC Medical Center, University of Southern California, Keck School of Medicine, 1200 N. State St., GNH-3900, Los Angeles, CA 90033, USA. zalavras@usc.edu
Rigopoulos
Nick
N
Ahlmann
Elke
E
Patzakis
Michael J
MJ
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000401:mortality; D003646:Debridement; D004188:Disarticulation / Q000401:mortality*; D019115:Fasciitis, Necrotizing / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005734:Gangrene / Q000401:mortality* / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000401:mortality / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index