Bilateral hip disarticulation in paraplegics

Background: Decubitus ulcers are severe challenges to paraplegic patients, as well as to the medical providers caring for such disabled persons. Severe, chronic infection often can lead to death, especially in developing countries. Sometimes, hip disarticulation is the most appropriate surgical response to chronic ulceration. Objective: Report the results of bilateral disarticulations in 3 patients, one in Cambodia, and two in Australia. Methods: Chart reviews, examinations, and interviews with the patients were conducted to identify appropriate details of the indications and results. Results: Severe decubitus ulcers were successfully treated using the technique, without undue surgical complications. The general health of the patients was much improved. Conclusion: Bilateral hip disarticulations were performed as last stage salvage operations in three patients, who expressed satisfaction with the results, even though some problems with balance and recurrent ulceration persisted.