Traumatic hemipelvectomy before body image has developed

Traumatic hemipelvectomy is rarely observed because very few patients have survived from the initial trauma. We describe one male child who survived from this massive trauma with a good functional outcome. The boy was 28 months old when he was accidentally struck by a truck. He had severe open trauma of the pelvis and hemorrhage of the left lower limb. Amputation of the left hemipelvis, colostomy, cystostomy and removal of the left avulsed testicle were performed. Once healing had been achieved, he was transferred to our Department of Physical Medicine and Rehabilitation and rehabilitative management was begun, including prosthetic measurement and psychologic intervention for the patient and his parents. For 13 years of long-term follow-up, his prosthesis was readjusted annually. Now he is a 16-year-old middle school student. He is functioning remarkably well with a prosthesis. The psychologic report shows that he is emotionally stable and has good scholastic performance. Although hemipelvectomy appears to be a radical procedure in children, the potential for rehabilitation in a group of children before body image has developed appears to be unexpectedly good.

Las grandes desarticulaciones preservadoras / The extensive preservative desarticulation

Se ha revisado la experiencia del Hospital Universitario de Caracas en los últimos 11 años (1986-1996) en las grandes desarticulaciones encontrándose sólo 18 casos, la mayoría de ellos (16) son desarticulaciones de la cadera, una hemipelvectomía y una desarticulación interescápulo torácica. Se analizan también, más detalladamente, 2 casos de grandes desarticulaciones preservadoras: una operación de Tikhoff-Linberg y una hemipelvectomía interna por razones ortópedicas, operado exitosamente en el Hospital de Clínicas Caracas