Research Mentor Name
Dr. Richard Simman
Research Mentor Email Address
Institution / Department
Jobst Vascular Institute, ProMedica Health Network
Level of Research
Hip disarticulation (HD) is a radical lower extremity amputation performed by carefully transecting all muscles and nerves surrounding the hip joint and separating the leg at the joint capsule. This procedure accounts for only 0.5% of all lower extremity amputations in the United States. It is generally performed due to malignant tumors, trauma and limb ischemia. However, it also has a role to play in wound care including management of severe lower extremity infections. It is considered a last resort to be used as a life-preserving measure under emergent circumstances due to high rates of morbidity and mortality.
In this case series, we discuss four patients who underwent hip disarticulation specifically for wound care management. The procedure was performed due to various indications including necrotizing fasciitis, gangrene, stump necrosis from previous above the knee amputation and septic arthritis secondary to chronic osteomyelitis. Three of the operations were planned and one was emergent. The procedure was performed successfully in all four patients. Furthermore, all patients were eventually able to be discharged home or to a long term care facility.
Overall, we conclude that HD should be reserved as a life-saving treatment for various indications including infections or wounds that fail other modalities, limb ischemia, trauma and malignancy. Ideally, this procedure would be planned and done on proper candidates; however, hip disarticulation should still be a consideration in the emergent setting regardless of most optimal patients due to its life saving potential.
Medicine and Health Sciences
Klomparens, Kara; Abbas, Fuad; Lamaj, Sway; Rehman, Naveen; and Simman, Richard MD, "Hip Disarticulation in Wound Care: A Case Series" (2023). Medical Student Research Symposium. 193.