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

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Résumé

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.

Mots-clés

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