AB262. Case report: bilateral girdlestone: an old solution for a new problem

Background: Girdlestone procedure is an excision arthroplasty of the hip rarely used today. It was first described for the management of tuberculosis, the indications to perform it have significantly changed since.

Methods: A bilateral girdlestone was required for a well 50-year old lady presenting with paraplegia and severe muscle spasticity scissoring due to a traumatic brain injury acquired 10 years previously. On examination, there was bilateral hip adduction and subluxation causing pain. This patient was bed bound because of the position of the legs and poor sitting balance. For pain relief, perineal care and comfort measures a bilateral girdlestone procedure was carried out.

Results: Post operatively, the patient recovered well and was able to sit out and mobilize in an adapted chair.

Conclusions: There are few absolute and relative indications for this procedure however a bilateral salvage procedure was deemed necessary in this case for pain relief and improved quality of life.

Keywords: Girdlestone; salvage procedure; paraplegia; quality of life