title: [Giant recurrent trochanteric pressure sore: A complex medico-surgical care].
abstract: BACKGROUND
  Pressure sores are a frequent complication in spinal injured people. Their treatment is often long and complex.
  
  
  METHODS
  We report the case of a 60-year-old man affected with complete paraplegia who developed a right trochanteric pressure ulcer complicated with osteoarthritis of the coxofemoral joint. The treatment was done in three steps. First, a large excision of necrotic tissues and a femoral head-neck resection is performed. Then, the defect is partly covered with a Gluteus Maximus and a Biceps Femoris myocutaneous flaps. Finally, the residual defect is covered with a cutaneous pedicled groin flap called McGregor's flap. Later, the patient showed a right para-scrotal pressure sore on a heterotopic ossification of the ischial tuberosity.
  
  
  CONCLUSIONS
  McGregor's flap is rarely employed for treating trochanteric pressure sores. It was here the only pedicled flap available. It was necessary to autonomize it in order to get enough length and to place a hip external fixation. The para-scrotal pressure sore illustrates the fact that bone resection surgery lifts the weight-bearing zones and can lead to pressure sores in unusual locations.
  
  
  CONCLUSIONS
  The surgical treatment of these "giant" pressure sores requires a perfect collaboration between teams of rehabilitation and several surgical areas. Without a good adherence of the patient, the treatment is doomed to fail.
authors.affiliation: Service de médecine physique et réadaptation, hôpital Renée-Sabran, hospices civils de Lyon, boulevard Édouard-Herriot, 83400 Hyères, France.
authors.forename: S
authors.initials: S
authors.lastname: Pesenti
authors.affiliation: Service de médecine physique et réadaptation, hôpital Renée-Sabran, hospices civils de Lyon, boulevard Édouard-Herriot, 83400 Hyères, France. Electronic address: carine.ciceron@chu-lyon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Ciceron
authors.affiliation: Centre de la main, clinique Saint-Jean, 1, avenue Georges-Bizet, 83000 Toulon, France.
authors.forename: E
authors.initials: E
authors.lastname: Toledano
authors.affiliation: Service de chirurgie plastique et réparatrice, hôpital de La Conception, CHU de Marseille, 147, boulevard Baille, 13005 Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Niddam
authors.affiliation: Service de médecine physique et réadaptation, hôpital Renée-Sabran, hospices civils de Lyon, boulevard Édouard-Herriot, 83400 Hyères, France.
authors.forename: H
authors.initials: H
authors.lastname: Tournebise
mesh_terms: D016267:External Fixators; D006615:Hip; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap; D010264:Paraplegia / Q000150:complications; D010348:Patient Care Team; D003668:Pressure Ulcer / Q000209:etiology / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications
keywords: Escarre trochantérienne; Heterotopic ossification; Lambeau de McGregor; McGregor flap; Multidisciplinarity; Ossification hétérotopique; Paraplegia; Paraplégie; Pluridisciplinarité; Trochanteric pressure sore