Hindquarter Amputation - Ian Holloway 13/5/2002

Interinnominoabdominal amputation,

interilioabdominal amputation,

ilioabdominal amputation,


transpelvic amputation,



Mostly for malignancy (boneor soft tissue sarcoma) arising from the hip or femur such that limb salvage surgery or disarticulation is not possible.

Previously was used forinfection (eg TB)

Trauma – several casereports in the literature.

Preop preparation

Enemas, catheter, XM 10units

Blood conserved by use of Esmarch unless embolisation is a risk (? Venogram)


True lateral

Use sling to suspend foot


Anterior incision: starts atpubic tubercle; swings superiorly and laterally along inguinal ligament; alongcrest of ilium.

Posterior incision:continues distally and anteriorly around greater trochanter; then posteriorly and medially along gluteal fold, then superiorly between perineum and adductors.

Posterior flap

Includes gluteus maximus

Most authors recommend that internal illiac vessels must be preserved to avoid flap necrosis

Bleeding from the internal iliacs can be high. Some authors recommend tying the common iliacs.


Wound complications: flapnecrosis, wound infection

Tumour embolisation

Urinary fistula

Post op management

Prosthesesare available but often badly tolerated

Patientsoften prefer life on crutches


Gordon-Taylor British Journal of Surgery 1935


G Gordon-Taylor, P Wiles


Interinnomino-abdominal (hinquarter) amputation


BJS 1935;22:671-695


Retrospective review of authors’ series of 5 cases. Case reports.


Historical article. Gives extensive clinical, operative and pathological details of each case. Operative technique described. Reviews all previous cases.


Masterson Clinical Orthopaedics and Related Research 1998

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