PMC5316915_01
a: Acetabular cab in place; b and c: acetabular cap in the rectum; d: acetabular cap encapsulated by fibrous tissue; e and f: colonoscopy showing the tip of the endoprothesis
IPRS-06-03-g-001.jpg
PMC5316915_01_IPRS-06-03-g-001.jpg
F1
She received a 12-hole locking compression plate (LCP), three wire cerclages, a Palacos  spacer, as well as a gentamycin chain (Figure 1a (Fig. 1)). In March 2015 a follow-up computed tomography (CT) showed the head of the implanted Palacos  spacer inside her rectal cavity (Figure 1b and c (Fig. 1)). The first step in our department was the removal of the foreign body under general anesthesia through the anus without complications (Figure 1d (Fig. 1)). Afterwards a colonoscopy was performed showing the tip of the endoprothesis 3 cm aboral of the ileocecal region (Figure 1e and f (Fig. 1)).
a: Fistulas to the right distal thigh; b: preparation of the myo-cutaneous flap; c: specimen (right leg with adjacent wedge resection of the colon); d: tip of the endoprothesis within the colon; e: final myo-cutaneous flap; f: result at the end of the operation
IPRS-06-03-g-002.jpg
PMC5316915_01_IPRS-06-03-g-002.jpg
F2
Due to the chronic infection of the prosthesis with several fistulas to the gluteal region as well as to the lateral thigh (Figure 2a (Fig. 2)) and the penetration into the right colon we decided to perform a en bloc resection combining a right-leg amputation with a wedge resection of the right colon. Wound coverage was achieved by a large muscular cutaneous flap from the vastus, the rectus femoris and the adductal muscles (Figure 2b-f (Fig. 2)).