Hip Disarticulation / Hemi Pelvis Amputation
Such high amputations are more often performed for trauma or malignancy. If a patient has such bad peripheral arterial disease that their whole leg needs amputation, their general morbidity is so great they may well be palliated instead.
In the trauma setting these amputations are often required after blast injuries.
A raquet shaped incision is made around the thigh. The short external rotators and thigh muscles are divided at their bony attachments to the proximal femur. The muscle flaps are used to cover the exposed acetabulum after dislocation.
A hindquater amputation involves division of the symphysis pubis and the sacro-iliac joint to remove the hemi-pelvis. The external iliac vessels are tied off. The flap consists of skin and gluteus maximus.
