Limb salvage operations for patients with malignant bone tumors in the extremities
Journal
Tzu Chi Medical Journal
Journal Volume
17
Journal Issue
6
Pages
389-396+451
Date Issued
2005
Author(s)
Abstract
Neoadjuvant chemotherapy, modern imaging analyses, and developments in surgical techniques in recent decades have enabled limb salvage surgery to provide well-functioning, tumor-free, painless limbs through excision of the tumor with an adequate margin and proper reconstruction. With proper selection, patients are expected to have mostly intact body balance, a simple rehabilitation process, and an intact body image, but not at the expense of local recurrence and survival. Currently the indications of such a limb salvage procedure have been expanded to other non-malignant tumorous conditions in addition to malignant juxta-articular bone tumors in the extremities. Wide resection of a tumor can result in massive bone and soft-tissue defects. Currently, many options for reconstruction with limb salvage procedures are available, including resection arthrodesis, various bone graft techniques (vascularized or conventional autografts, allografts, or allograft/ endoprosthesis composites), Ilizarov leg lengthening, rotationplasty, reconstruction with custom-made oncological endoprostheses, etc. These have resulted in expected successes, while simultaneously producing biological or prosthesis-related complications due to their unique advantages and disadvantages. The choice of an option requires careful individual considerations, including imaging radiological staging, pathological staging, and the clinical status.
Subjects
Bone graft; Complications; Endoprosthetic reconstruction; Limb salvage operation; Modular oncological endoprosthesis
SDGs
Other Subjects
allograft; arthrodesis; autograft; balance disorder; bone graft; bone remodeling; bone tumor; cancer chemotherapy; cancer recurrence; cancer staging; cancer surgery; cancer survival; clinical trial; diagnostic imaging; endoprosthesis; human; Ilizarov technique; leg lengthening; limb salvage; patient selection; postoperative complication; review; rotation; soft tissue defect; staging; systematic review; treatment outcome
Type
review