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Spontaneous hip disarticulation associated with severe pressure sore ulceration

Published:November 17, 2008DOI:https://doi.org/10.1016/j.bjps.2008.08.073
      Pressure sores remain a frequent challenge for today's plastic surgeon. The management of these wounds is fraught with high recurrence rates.
      • Disa J.J.
      • Carlton J.M.
      • Goldberg N.H.
      Efficacy of operative cure in pressure sore patients.
      Multidisciplinary management is necessary.
      • Kierney P.C.
      • Engrav L.H.
      • Isik F.F.
      • et al.
      Results of 268 pressure sores in 158 patients managed jointly by plastic surgery and rehabilitation medicine.
      Greater understanding of the fact that optimum perioperative care and nutrition is as important as flap choice and technique has improved management of ulcers.
      • Kierney P.C.
      • Engrav L.H.
      • Isik F.F.
      • et al.
      Results of 268 pressure sores in 158 patients managed jointly by plastic surgery and rehabilitation medicine.
      Unfortunately, very complex cases in which limb salvage is not an option may present. In this scenario, amputation or bone removal followed by fillet flap closure utilizing remaining soft tissue is likely the best option. Severe trochanteric ulceration of this magntitude is not frequently described. In the present case, a long standing trochanteric pressure sore progressed to spontaneous, complete extrusion of the right acetabulum and femoral head.
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