RESEARCH ARTICLE


Is Head and Neck Resection of the Femur (Girdlestone’s Procedure) Still Relevant? Indications and Results About 24 Cases



Mamoudou Sawadogo1, *, Hamado Kafando1, Salam Ouedraogo2, Alexandre Stanislas Korsaga1, Souleymane Ouedraogo2, Sayouba Tinto1, Anatole Jean Innocent Ouedraogo1, Mohamed Tall1, Songahir Christophe DA1
1 Yalgado Ouedraogo University Hospital 03 BP 7022 Ouagadougou 03 Burkina Faso
2 Ouahigouya Regional University Hospital Center BP 36, Ouahigouya Burkina Faso


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© 2018 Sawadogo et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Yalgado Ouedraogo University Hospital, Dr. Mamoudou Sawadogo, 11 BP 188 Ouagadougou CMS 11 Burkina Faso; Tel: +226 70267343; E-mail: smamoudou@hotmail.com


Abstract

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.

Keywords: Resection, Head, Neck, Femur, Procedure, Girdlestone.