VASTUS LATERALIS FLAPS FOR CHRONIC RECALCITRANT HIP INFECTION

Between January 1991 and May 1994, 11 patients with chronic recalcitra nt infection of the hip joint were successfully treated by transpositi on of a vastus lateralis flap. The average duration of the infection w as 7.9 months. The patients had undergone an average of 2.8 procedures in an attempt to eradicate the infection before transposition of the flap. Three patients had recurrence of drainage after the procedure an d were successfully treated with antibiotics and local debridement. De layed exchange total hip arthroplasty was performed in 2 patients. All the patients achieved wound healing and infection resolution. This fl ap has several advantages. The donor site has not usually been scarred from previous operations; the flap has a consistent vascular pedicle which permits a wide arc of rotation; knee extension is unaffected; th e transposed portion of the vastus lateralis can act as a cushion betw een the acetabulum and the proximal femur; it may also act as a tether to prevent extreme proximal migration of the femur: In the management of chronic recalcitrant infection of the hip, use of a transposition flap can be combined with a Girdlestone arthroplasty. It can also be a n interim procedure before a further total joint arthroplasty.