TITLE:
Hip Disarticulation for Severely Injured Lowerlimbs about 11 Cases and Literature Review
AUTHORS:
Koné Samba, Dogba Eric, Godefroy Adibo, Pemboura Dominique, Koffi Akue, Ledion Anicet, Bana Abdoulay, Agoh Serge
KEYWORDS:
Disarticulation, Hip, Severely Injured, Limb
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.8 No.2,
February
26,
2018
ABSTRACT: Introduction: Hip disarticulation (HD) consists of a removal of the entire lower limb at the height of the hip-femoral joint. It is an extremely mutilating intervention with a major functional and psychological impact. We report 11 cases of hip disarticulation following severe trauma of the lower limb. The aim of the study is to analyze the frequency, the clinical aspect and present their management results and the patients’ becoming. Patients and methods: A 13-year retrospective study was conducted in our traumatology department. Eleven cases of hip disarticulation were identified. We analyzed the following data: the epidemiological parameters (age, sex, accidentology), Clinico-radiological (gravity injury severity score (ISS), mangled extremity severity score (MESS), associated lesion), admission time, evolutionary aspects and finally the patients’ becoming). Results: The series consisted of 3 males and 8 females, with an average age of 24 years. All experienced a HD following the lower limb severe traumatism due to a road accident. The category of victims was dominated by pedestrians. The average admission time was 13 hours with extremes of 9 and 28 hours. Our series average ISS was 28 with extremes of 15 - 69. The associated lesions were dominated by Gustilo Type III A III B open fractures. The mean MESS at admission was 10 with extremes from 8 to 14. Complications were dominated by infection (at least 72%) with a mortality rate of 36.36%. Algohallucinosis affects all these patients post-operatively at varied degrees. Aggressive components and denial of bereavement were most noticeable. Only one patient was able to honor her Canadian prosthetic equipment. All the victims changed their personal and professional activities. Conclusion: HD is an extremely mutilating surgery with a major functional and psychological impact. Quality of life of the disarticulated patient is taught because of the persistence of the pain, the occurrence of a major motor handicap and the impossibility of apparatus limiting the social and relational life.