PATIENTS AND METHODS This retrospective survey involved 26 patients (20 men and 6 women) with a mean age of 39 years (23–66; s.d.=13.5) and a post-injury delay of 14.5 years (2.5–39; s.d.=5.16). The spinal cord lesion was post-traumatic for 21 patients. The other etiologies were multiple sclerosis (MS; 3 cases), ischemic myelitis (1 case) and primary syringomyelia (1 case). Thirty-three sepses of the hip (SH), always due to pelvic pressure sores, were treated between 1988 and 2009 in a French SCI referral center. All the patients were hospitalized in one specific
SCI unit of the PRM (Physical and Rehabilitation Medicine) department for a few days before surgery to evaluate the intended anesthetic and surgical procedures and to prepare for the operation. All the patients were returned from the plastic surgery department to the specialized PRM unit on the same day as the surgery or, at the latest, the next day. During the postoperative period, the patients lay supine on a low-air-loss bed. We used 3kg skeletal bonded traction over 3 weeks. The suction drains were monitored several times a day; the sutures were removed after 21 days. Four weeks of permanent hip extension were managed with pillows and sheets in bed. Then, hip flexion postures were started and increased day by day. A gradual return to the sitting position in the wheelchair began after 6 weeks of confinement.