Journal of Clinical & Experimental Orthopaedics

Girdlestone Procedure: A Viable Alternative for Displaced Femoral Neck Fractures

Background: The Girdlestone procedure (femoral head ostectomy) is a salvage operation that may be used for treatment of infected hip arthroplasty in non-ambulatory patients or those unable to tolerate a two-stage surgery. Infection control is well-established and generally pain is tolerable. The purpose of this study was to evaluate surgical risk associated with Girdlestone procedure as a suitable alternative treatment of displaced femoral neck fracture in very highly-comorbid patients at high-risk for tolerating hemiarthroplasty.

Methods: A retrospective chart review of 30 non-ambulatory patients over 10 years who underwent Girdlestone procedures for displaced femoral neck fractures due to extremely-high anesthetic and/or infection risk.

Results: Girdlestone procedures were reasonably well-tolerated in very high-risk surgical candidates with displaced femoral neck fractures and required lower reoperation rates than closed reduction and percutaneous pinning. Perioperative, 90-day, and 1-year mortality rate were 3% (1/30), 53% (16/30), and 67% (20/30), respectively. Of patients who followed-up after surgery, 33% maintained their previous functional mobility and 66% reported improved mobility after their Girdlestone procedure.

Conclusion: Girdlestone procedures serve as a well-tolerated alternative procedure for displaced femoral neck fractures and should be considered when treating a patient who is non-ambulatory.

Author(s): Cameron Crasto, Scott Huff and Nabil Ebraheim

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