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Total hip replacement in patient with proximal femoral deficiency


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57-year-old male
Multiple failed DHS for trochanteric fracture with sepsis, non-ambulatory for 18 months, restricted knee and hip motion
Comorbidities: DM, chronic alcoholic and smoker

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Corresponding Author

Mital Patel
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  1. Sep 04, 2011

    Mital

    With the history of multiple prior surgeries and infection I would have thought that a two stage procedure would have been considered. Initial stage to remove the necrotic tissue and do an aggressive debridement + insertion of cement spacer. Then second procedure to revise to total hip replacement.

    1. Sep 04, 2011

      when last dhs was done thorough debridement was done.patient presented to us 6 months after it. so there identifiable proximal femur when patient was debrided but then reabsorbtion led to x ray which shows only a sequestrum like fragment. Then patient present to us with superficial abscess we debrided it and continued the antibiotics for around 6 weeks. Then crp was measured regularly for around 3 months, only when it was found negative we went ahead with the THR in onestage removal of the fragment and THR, as we thought each surgery additional would cause further tissue damage and make reconstruction more complicated.