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2018 ; 12
(ä): 69-74
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Is Head and Neck Resection of the Femur (Girdlestone s Procedure) Still Relevant?
Indications and Results About 24 Cases
#MMPMID29541272
Sawadogo M
; Kafando H
; Ouedraogo S
; Korsaga AS
; Ouedraogo S
; Tinto S
; Ouedraogo AJI
; Tall M
; DA SC
Open Orthop J
2018[]; 12
(ä): 69-74
PMID29541272
show ga
INTRODUCTION: Head and neck resection of the femur was described by Girdlestone
in 1928 in the treatment of coxalgia. Very invasive at the beginning, this
intervention is much less so today, but the term of "Girdlestone's operation" or
"Girdlestone's procedure" has remained in use. The reported results are
controversial. In resource-limited countries, Girdlestone's procedure is often
indicated for lack of a better one. In this context, we report the results of a
series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso)
with the aim of showing that this technique remains valid and can be benefit.
METHODS: This was a retrospective descriptive study of 24 patients who had
benefited from the procedure for cervical fracture sequelae, failure of
arthroplasty or osteosynthesis, or osteonecrosis. All were operated by
posterolateral approach, under spinal anesthesia and followed for 5 years with
evaluation of the anatomical and functional results using the rating of Postel
and Merle d'Aubigné (PMA). RESULTS: All patients had Trendelenburg lameness with
a mean shortening of 3.5 cm. They were all autonomous with walking aids and the
PMA score ranged from 16 to 14. Discussion: although the results obtained are not
excellent, they are relatively good and have allowed all our patients to recover
an acceptable autonomy, compatible with certain independence in everyday life.
CONCLUSION: The Girdlestone's procedure cannot be a first intention indication,
but retains a place in the therapeutic arsenal of certain affections of the hip.