A Miserable Case of Total Hip Replacement Caused by Postirradiation Necrosis

We experienced a miserable case of postirradiation femoral head necrosis. Osteomyelitis due to a screw penetration into the cecum was followed by total hip replacement.The patient is a sixty seven years old woman. As she was injured by inoperable uterus cancer at fifty one years old, 60Co irradiation therapy was done. As postirradiation necrosis occured 5 years after irradiation, total hip replacement (Mckee-Farrar type) was done. However, bone necrosis area in iliac bone due to irradiation progressed gradually, and anchoring screw migrated proximally into the cecum. Then the fistel formed at the region of rt. major trochanter. In fistelography, contrast medium leaked out into the cecum. So after iliocecectomy and anastomosis of colon, removal of prosthesis and local continuous suction irrigation was done twice. Since then, there has been no recurrence.