Complications after hip disarticulation and hemipelvectomy

Abstract

Introduction: Hip disarticulation and hemipelvectomy are surgical procedures with a high rate of local complications: swollen scrotum/labia, superficial necrosis, infection, and wound dehiscence. Aim: We present local complications in our series. Material and methods: 17 patients were included in the study, there were 16 cases of malignant tumors and one case of osteomyelitis. Twelve of the tumors were soft tissue tumors, and four were malignant bone tumors. The descriptive statistical methods and methods for hypothesis testing used were the following: mean value, standard deviation, and absolute numbers as structure indicators, the t-test, and Fisher's exact test. Results: Local complications were observed in ten patients. Scrotum/labia edema was observed in five, superficial necrosis in four, wound infection in six, and wound dehiscence in seven cases. A single complication was observed in three patients; two and three complications were observed in three cases, each; and four complications were observed in one patient. No significant statistical difference was found between male and female patients (p=1.000). Patients with complications were significantly older (p=0.008). The correlation was found only between wound infection and dehiscence (p=0.001). Staphylococcus aureus was found in three cases, Enterococcus faecalis in one, Pseudomonas aeruginosa in three, Proteus mirabilis in two, and Acinetobacter spp. in one. Two patients had a single agent infection, the remaining four had polymicrobial infection. The complication rate was 58.8%, with wound infection being the most common one. Age was found as a possible predictor. This might be in relation to the condition of the blood vessels, but also with the general condition of the patient. Conclusion: Complications in hip disarticulation/hemipelvectomy vary from insignificant to life-threatening, prolonging recovery and rehabilitation.