ABSTRACT
Hip disarticulation This operation is progressively becoming less common for soft tissue tumors. Essentially it involves an incision similar to that for hemipelvectomy, placed 4-7 cm more distally. The anterior femoral vessels are ligated and divided, as is the femoral nerve. This operation is much simpler, requiring detachment of the muscles from their attachments to the pelvis,
with similar extension posteriorly to divide the gluteal muscles at the level of the skin incision coming down just onto the greater tuberosity. All the median muscles can then be divided, including the gluteus medius, piriformis and gemelli. Posteriorly, the sciatic nerve is sharply divided. Liberal use of rotation of the hip will make this procedure quite simple. The head of the femur is easily dislocated from the acetabulum, and the round ligament divided. Primary closure of muscle to muscle can be obtained, and skin sutures over suction drains appropriately placed.
