Bilateral hip disarticulation in paraplegics with decubitus ulcers.

A small percentage of paraplegic patients develop chronic decubitus ulcers that are unresponsive to the usual plastic surgical maneuvers. We used anatomic and nonanatomic (filleting) approaches to hip disarticulation in three patients with severe chronic cavernous decubitus ulcers. All patients were rehabilitated to wheelchair ambulation, with subsequent healing of the operative sites. This type of therapy might be considered in paraplegics with less compelling reasons for amputation, because of the associated rehabilitation potential.